Is This Face for You?
Self - November 1994
Sophisticated changes in technique, new instruments and advanced facial implants have given surgeons a keener respect for facial idiosyncrasies. Patients achieve better, longer-lasting results when they do procedures at the beginning of the aging process while the skin still has considerable elasticity. Mid-facial implants are used most frequently for patients in their thirties and forties not yet ready for full face lifts. Submalar and malar implants are triangular, curved pieces of silicone rubber that are shaped to conform with the bones of the face, not to be confused with the liquid silicone used in breast implants.
"You're elevating the soft tissues in the middle of the face and creating the illusion of increased soft tissue bulk," says William Binder, MD, a facial plastic surgeon from Beverly Hills who invented the implant.
Submalar implants can be inserted alone, or they can be combined with a traditional face lift to hoist wrinkles and folds around the mouth that traditional face lifts might miss. The new anatomically designed malar implants offer significant improvements over the "one shape fits all" implants of the past. Today's cheek implants are shaped more like the actual cheekbone,with tapered edges that make the projection look far more natural. Chin implants are also much better. Now surgeons are using "wraparound" implants that can resculpt almost the entire jawline. Used with liposuction, moderate jowl fat can be sucked away while the wraparaound chin implant is used to support skin and tissue. Many of the new facial implants require no more than a local anesthetic with heavy sedation and two hours of surgery. As an alternative, some doctors are offering to remove the "buccal fat" underneath the cheekbone. But the natural process of aging removes mid-face fat anyway, so it may be better to spring for more expensive cheek implants. Computer-imaged implants now offer plastic surgeons a new technological edge. At the moment, mass-produced implants come in standard sizes. But according to Dr. Binder, within the next few years, the customized compu-built implants currently used for major reconstructive surgery will be available-though expensive-for elective surgery. The precision results are based on three-dimensional computer images. A few simple rules for finding the right surgeon: Know your chosen doctor's credentials, see as many examples of his handiwork as possible, and listen carefully to what your doctor is saying.
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