More than Meets the Eye
Consultant plastic surgeon Mr James McDiarmid FRCS (Plast), explains the potential of periorbital surgery in transforming our appearance As our faces age changes occur in the periorbital region at different ...
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Who does it?
Plastic Surgeon
Face Surgeon
Eye Surgeon
Cosmetic Doctor
Cosmetic Dermatologist
Cosmetic Dentist
Cosmetic Nurse
What is it?
There are two main aims behind cheek enhancement – for the older patient, the idea is usually to restore volume to the mid-face area, which in turn promotes a much younger look.
However, you might also consider this procedure at any age if you feel your face is flat and you wish to achieve the chiselled, pronounced cheekbones of celebs like Keira Knightley.
There are a number of non- surgical options (see below). The surgical options are either cheek implants, or a procedure called malar osteotomy.
Who is suitable?
Volume loss is now recognised as one of the biggest giveaways of ageing and affects most of us once we pass the age of 40, so if you’ve been thinking you’re starting to look a bit gaunt in the cheek area lately, you’re probably right and so you might well be a candidate for cheek enhancement.
The best surgical option in this scenario is probably cheek implants, although you will need to undergo a thorough consultation with a surgeon to confirm this.
If you’ve always had a very flat or narrow face and your aim is not so much to look younger but to give your face more structure, cheek implants could be an option or you might want to consider malar osteotomy.
It’s probably best to go and see a surgeon who specialises in this area, to determine which is the best method for you.
What’s the treatment like?
Cheek implants are usually placed from within the mouth, so the surgeon will make an incision in the inner cheek and then position the implant either high in the upper cheek for the Keira look or in the mid cheek if your aim was anti-ageing.
The cut can be made under the lower lash line, but this will leave a visible scar. Either way, the procedure can be performed under either local or general anaesthetic and can take anything from 30 minutes to two hours, depending on the implant.
Malar osteotomy is a more specialised procedure. The operation involves cutting into the cheekbone itself and repositioning it to make it more prominent.
Again, this tends to be performed from inside the mouth, and is usually done using a general anaesthetic. The process usually takes about one to two hours.
What happens afterwards?
If you’ve opted for general anaesthetic, you’ll need to rest for a while to allow it to wear off.
Implants tend to leave you quite sore and swollen, but that usually fades quickly and you will be back to normal within a week.
Malar osteotomy does take longer to recover from – you should allow a few weeks before facial movements will be comfortable, and you may need to wear a compression garment to aid the healing process.
Will there be a scar?
As incisions are made inside the mouth, there is no visible scar.

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