Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Facial augmentation procedures are typically performed in an accredited ambulatory surgery center or a hospital setting. The type of anesthesia used depends on the complexity of the procedure. Simple chin implants or fat grafting may be performed under local anesthesia with IV sedation (twilight sleep).
More extensive procedures, such as custom jaw angles, multiple implants, or combined facelifts, usually require general anesthesia to ensure the patient’s airway is protected and they remain completely still. The anesthesiologist monitors vital signs continuously throughout the operation.
The surgeon begins by making precise incisions to access the underlying bone or soft tissue. For cheek implants, incisions are often made inside the mouth (intraoral) above the gum line, leaving no visible scars. Lower eyelid incisions are another option.
Chin and jaw implants can also be placed through intraoral incisions or through a small incision under the chin (submental). The choice of incision depends on the implant size, the need for screw fixation, and the patient’s anatomy. Fat grafting requires tiny stab incisions for the cannula, usually hidden in skin creases.
Once the pocket is created directly on top of the bone (subperiosteal), the implant is inserted. The surgeon ensures the implant sits flush against the bone without rocking or gaps. This is where the precision of the pocket creation is critical.
To prevent the implant from migrating or moving over time, it is often secured to the bone. This can be done using titanium microscrews or sutures. Fixation is significant for custom implants and jaw angle implants that are subject to strong muscle forces.
For fat grafting procedures, the surgeon first harvests fat from the donor site (abdomen or thighs) using gentle liposuction. The fat is then processed to remove fluids and oil.
The purified fat is injected into the face using fine cannulas. The surgeon places the fat in minute droplets at multiple levels—deep on the bone for support and superficially for contour. This layering technique ensures smooth results and maximizes cell survival.
After the augmentation is complete, the incisions are closed. Intraoral incisions are closed with absorbable sutures that dissolve on their own. External incisions are closed with fine sutures that are removed in a week.
A compression dressing or chin strap is often applied to minimize swelling and hold the tissues in place. For fat grafting, small tapes are placed over the injection sites. Ice packs are applied immediately to control edema.
The patient is moved to the recovery room, where they are monitored as the anesthesia wears off. The face will feel tight and swollen. Numbness is common due to the local anesthetic and the manipulation of sensory nerves.
Patients are typically discharged the same day once they are stable and able to drink fluids. They must be driven home by a responsible adult. Instructions for head elevation and ice application are reinforced before discharge.
Pain following facial augmentation is generally moderate. Patients typically describe it as a feeling of pressure or tightness rather than sharp pain. Oral pain medication is prescribed for the first few days.
Antibiotics are prescribed to prevent infection, especially for implants placed through the mouth. Patients are instructed to rinse with an antiseptic mouthwash to keep oral incisions clean. Avoiding tongue pressure on the incision line is crucial.
For procedures involving intraoral incisions, a soft or liquid diet is required for the first few days to a week. Chewing can pull on the stitches and displace implants before they have settled.
Patients are advised to avoid hot, spicy, and sharp foods (such as chips) that could irritate the incision. Staying hydrated is essential, but straws should be avoided as the suction can create negative pressure in the mouth.
Swelling is the most significant aspect of recovery. It peaks around days 3 or 4 and can temporarily distort facial features. Bruising may migrate down the neck due to gravity.
Keeping the head elevated at a 45-degree angle, even while sleeping, is critical for the first week. Constant icing for the first 48 hours helps significantly. Arnica supplements may be continued to speed up bruise resolution.
Oral hygiene is paramount. Patients must rinse their mouth gently after every meal to prevent food particles from lodging in the incisions. Brushing teeth should be done carefully, avoiding the incision areas.
External incisions should be kept clean and covered with antibiotic ointment as directed. Patients can usually shower the day after surgery, but should avoid getting high-pressure water directly on the face.
Strenuous activity increases blood pressure and can cause bleeding or increased swelling. Patients are advised to avoid the gym, heavy lifting, and bending over for at least 2 to 3 weeks.
Contact sports are strictly prohibited for 6 to 8 weeks to allow the implants to fixate and the bones to heal. Returning to desk work is usually possible after 1 week, though visible swelling may persist.
Numbness in the lip, chin, or cheek is common after augmentation due to stretching of the mental or infraorbital nerves. This is usually temporary and resolves over weeks to months as the nerves recover.
Sensations of tingling or itching are signs of nerve regeneration. Permanent numbness is rare, but it is discussed during consultation. Patients should be patient with sensory recovery.
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Immediately after surgery, you will look swollen and distorted. It is important not to judge the results for several weeks. You will look like a swollen version of yourself. The true definition will emerge as the edema subsides.
Yes, you can talk, but your movement may be stiff due to swelling and the chin strap. It is best to minimize excessive talking for the first few days to allow the oral incisions to heal without tension.
You must sleep on your back with your head elevated on two or three pillows. Sleeping on your side or stomach can increase swelling on one side or displace the implants/fat before they are set.
It is normal to feel the implant with your tongue or fingers initially due to swelling and stiffness. As the tissues heal and soften, the implant should become less perceptible and feel like your own bone.
You can brush the teeth not involved in the surgery area gently, starting the day after. For the area near the incision, use a soft baby toothbrush or just the prescribed mouthwash for the first week to avoid tearing the stitches.
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