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Cheek and Chin Augmentation

Cheek and chin augmentation are two different yet related procedures.

Cheek Augemtation

Dr Zukowski and his staff at the Zukowski Center are renowned worldwide for being the best in FFS Facial Feminization Surgery. Based in Chicago America, Mark Zukowski is recognized within the transgender community as being the best.Cheek augmentation is typically a procedure that can be performed either with fat grafting alone in a small percentage of cases or fat grafting combined with some form of cheek implant in the majority of cases.  Typically, the implants commonly used are either silicone or a porous plastic material called Medpor.  I have been working with Medpor for over 18 years and find it to be a vastly superior material to silicone implants which I initially trained and practiced with.  The problem with silicone is that they are near impossible to fix to the bone which allows them to move around in the immediate post-op period and often causes a malposition of the implant.  Also, silicone implants can come out thru the skin years later.  Silicone implants have been designed to try to do too many things in terms of augmenting both bone and soft tissue, and I philosophically look upon cheek implants as something to primarily augment bone.  Fat grafting is complimentary to the cheek implant and is used to further augment and make more symmetrical the soft tissue fill over the cheek.  When a women smiles, it’s that very beautiful “apple of the cheek” that elevates to give a very pleasing contour and adds sensuality to the eye.  A cheek implant should not augment the width of the cheeks very much, but instead they should augment the front of the cheeks – that area directly below the eye.  When one looks at a woman in side profile, one finds a greater fullness in the area under the eye.  Also, in front projection, fuller cheeks tend to decrease the midface height which is longer in males.  This gives an individual’s face more of a heart shape where the forehead is rounded out and shortened, the cheeks are brought out similar to the middle of the heart and ultimately the neck and chin come to more of a point in the heart.  The Medpor cheek implants that I use were ironically designed by a colleague who does not do FFS.  They are designed to augment primarily the forward projection of the cheek bone underneath the eye with minimal augmentation of the outside of the cheeks.  The Medpor cheek implants incorporate nicely in the soft tissue and bone, and they can be contoured on the table further and sculpted to match the anatomical imperfections that may be found in terms of symmetry.  They are typically fixed with a medical grade titanium screw which insures that they will not move.  These implants are typically placed either through an inside the mouth approach or thru a lower eyelid approach.  In patients undergoing antibiotic irrigation as well as antibiotic use, there is no difference in infection rates between silicone and porous implants.  In fact, if anything with porous implants you are able to pull antibiotic solution into the small microspores of the implant prior to placing them into the body, giving a much more effective matrix to prevent infection and allowing a greater vascular formation within the implant matrix.  With solid silicone, you tend to build up a very thick, shiny scar capsule that is rather impervious to a new vascularity and provides a greater opportunity for infection.

Chin Augmentation

Dr Zukowski and his staff at the Zukowski Center are renowned worldwide for being the best in FFS Facial Feminization Surgery. Based in Chicago America, Mark Zukowski is recognized within the transgender community as being the best.Often a chin implant may be suggested to patients to increase chin projection by inexperienced FFS surgeons.  It is very infrequent that one augments the chin if one is able to successfully create an effective feminine concavity to the soft tissue of the neck.  Augmenting the chin with traditional implants is usually a very masculinizing procedure.  I use a one-piece Medpor “button” chin implant that fits beautifully over a newly contoured chin prominence and is fixed with a screw giving a very contoured forward projection to the chin in those infrequent cases that require an implant. Because I am able to give you a significant feminine and youthful concavity to the neck, it is rare to need a chin implant as a matter of routine.   In all cases, Medpor is an excellent implant to be utilized anywhere on the face for both feminization as well as masculinization.  I have been informed by the representative from the implant company that I am the number one surgeon in Chicago using Medpor implants in the face for cosmetic purposes.

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