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DONALD J. CAPUANO, M.D.
Plastic Surgeon

Malar augmentation surgery, i.e. enlargement of the cheekbones or areas around the cheek, can provide satisfaction to patients.

This procedure involves making incisions in the inner cheek areas, forming a pocket and placing a silicone implant into the area. The Doctor will outline this for you.

This procedure is usually performed under local (Novocain-like) anesthesia with IV. sedation, i.e. calming medications given through a vein or by mouth. The surgery lasts approximately 1 hour, after which you will have time to recover from the surgery at the office or Ambulatory Surgery Center. You are usually able to go home approximately 2 hours following surgery.

You will have tape and/or a dressing over the area, which should remain clean, dry and on until you are seen in the office. A soft diet is required for the first few days, and you will be given instructions regarding mouth care.

In some cases, stitches are placed through the skin of the cheeks to stabilize the implant. These stitches, if used, are usually removed between five to seven days following surgery.

You will be given prescriptions and/or asked to purchase over-the- counter medications to take following surgery. Please take all medicines as directed. If you have a problem with any medicine, call the office.

Implantation (the use of silicone implants) in surgery is an elective procedure, and you must be well counseled of the risks vs. the benefits of same.

Some of the possible problems and complications that are talked about but rarely seen include (but are not limited to) the following: -Bone changes under the implant- -Shifting of the implant in the pocket- -Buckling of an implant- -Change in position- -Tissue problems over the implant with scarring- -Implant working itself through the skin- -"Rejection" of the implant- -Excessive scar tissue around the implant (some fibrous tissue does surround the implant in all cases)- -Excessive firmness- -Discomfort- -Pain- -Infection- -Bleeding- -Poor wound healing- -Collections of blood- -Collections of fluid- -Nerve damage- -Nerve irritation- -Pain in the area- -Loss of feeling- -Intolerance to the implant-

Because of the differences in patients' physical responses to implants, and the differences in the underlying tissues and bone, along with surgical and medical treatment, possible complications or trauma, the implants should not be considered things that are forever. As with any other part of the body, i.e. teeth, bones, and other body structures, there is a possibility of loss - tooth loss, bone loss, etc. over time. In the same manner, implants may not last a lifetime, although they have been known to do so.

In the event that the implants are removed, you must be aware that while in some patients the results might be very similar to the pre-operative look, this cannot be guaranteed. Many factors determine the eventual result, including skin elasticity, the length of time the implant was in place, the age of the patient, etc.

While the above problems and complications are numerous and scary, the fact is that for the most part implant surgery is a procedure which is well tolerated. The percentage of serious problems approaches zero. There have been reports wherein implants had to be removed. When silicone implants are used, removal is usually relatively straight forward. Other types of implants, such as those made of Teflon, can be more difficult to remove. This office currently uses only silicone implants.

If you have any questions regarding this information, let the Doctor or office staff know.
If you have questions regarding this information, or have questions about any other surgical procedures, call the office at 585-225-0680.

INFORMATION REGARDING MALAR IMPLANTS

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