Facial implants

Facial implant surgery

Facial implant surgery is a form of cosmetic surgery used to change people’s facial contours or provide more balance to their face and features. Facial implant surgery also restores shape to a face after trauma or major disease (such as cancer). Implants may be made of human tissue or synthetic materials such as silicone or polythene.

Some common areas where implants are inserted include the cheeks, chin and jaw.

Some people choose to have cheek implants because they think their cheeks look flat or sunken. Cheek implants can make the cheeks look larger, higher or fuller.

People usually choose to have chin implants because they think their chin looks too small. Sometimes, a medical practitioner may recommend a chin implant to a person having reparative nose surgery (rhinoplasty). This is to provide facial proportion, as the size of the chin may influence how the nose looks.

If you are concerned about the way you look, or are thinking about cosmetic treatments to boost your confidence, there are alternatives. Talking to a counsellor or psychologist may help you overcome your concerns about your appearance.

Changes to laws that affect cosmetic procedures

In 2018, amendments were made to the Health Services Act 1988 to regulate all surgery, including cosmetic surgery. The changes specified that:

• all surgery must be carried out in a registered private hospital or day procedure centre
• liposuction and anaesthesia, including intravenous sedation and anything more than a low dose of local anaesthetic, must be carried out in a registered private hospital or day procedure centre.

This means that it is now illegal in Victoria for:

• any surgery (including cosmetic surgery) to be performed in facilities that are not registered with the Victorian Department of Health and Human Services
• anaesthetic (other than low doses of local anaesthetic) to be administered in an unregistered facility.

How do I know if a facility or health service establishment is registered?

To find out if a facility is registered, you can:

• visit the Department of Health Private hospitals page and expand the ‘contact details for private hospitals’ link
• email the Department’s Private Hospitals Unit privatehospitals@health.vic.gov.au
• ask to see the facility’s certificate of registration (this is usually on display in an obvious place where consumers can see it easily).

You can also contact the unit to report suspected illegal activity or for further queries regarding liposuction, cosmetic surgery or anaesthesia in Victoria.

Things to consider before having facial implant surgery

Facial implant surgery is a highly individualised surgical procedure and may not be suitable for everyone. Always talk to your medical practitioner before making a decision.

Before you choose to have facial implant surgery, some important issues to keep in mind include:

• Some facial implants are made from silicone. Concerns have been raised about the safety of silicone implants but currently there is no clear scientific evidence that silicone is a harmful substance.
• Think about the financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance companies. For more information:
  • Ask your medical practitioner about any out-of-pocket costs you can expect, and if you will be eligible for a rebate.
  • Visit PrivateHealth.gov.au for more information on private health insurance.
• Smokers are at increased risk of complications. To decrease the risk of these complications, and for your general health and wellbeing, try to quit smoking before having surgery.
• Consider asking another medical practitioner for a second opinion. It is important to have as much information as possible before deciding to have facial implant surgery.

Finding a qualified medical practitioner

Ask your GP for advice on a suitable and reputable medical practitioner or hospital where facial implant surgery is performed.

At your first consultation, ask the medical practitioner about their training and experience.

This procedure should be done by a medical practitioner who is specially trained to perform facial implant surgeries and has a lot of experience in carrying out this type of procedure. Ask to see the practitioner’s certificates that show them to be qualified to perform this specialised surgery.

All doctors practising in Victoria must be registered with the Medical Board of Australia (the Board). Find out if your medical practitioner is registered with the Board by searching on the AHPRA website.

Your current medical status and facial implants

If you are considering having facial implant surgery, you need to discuss your current medical status with your medical practitioner. This includes discussing:

• Your physical health – including your past medical history, such as diseases, illnesses, surgeries, immunisations and current physical status, which will include your diet and exercise regime. This would be a good time for the medical practitioner to check your blood pressure, temperature, heart rate/rhythm, oxygen saturation and respiratory rate
• Your mental health – any mental illnesses or issues and their treatments
• Medications you are currently on, including vitamins and supplements
• Past reactions to medications
• Any allergies you have.

As a result of this discussion, your medical practitioner will be able to assess the risks and possible complications of the surgery for you. They will also be able to tell you what preparations you will need to make to ensure your recovery from surgery is as smooth as possible.

Facial implant surgery – what happens during surgery

All surgery, including facial implant surgery, must be performed within licensed and accredited facilities. A registered anaesthetist must be present to treat you for any adverse reaction you may have to the anaesthetic. You can check if your anaesthetist is registered by searching on the AHPRA website.

Facial implant surgery may be performed using local anaesthetic and sedation, or a general anaesthetic. Your medical practitioner will advise on which option is best for you.

Cheek implant surgery

Cheek implant surgery usually takes about 30 to 45 minutes. If you are just having implants, the steps generally include:

• An incision (cut) is made either inside your upper lip or through your lower eyelid.
• A pocket is formed and the implant is inserted.
• The implant is held in place by the cheek muscles, stitches or metal screws.
• Stitches are used to close the incisions inside your mouth – these usually dissolve within about 10 days.

When cheek implants are being placed as part of another cosmetic procedure (such as a facelift, forehead lift or eyelid surgery), the implants may be inserted through the incisions made for those procedures.

Chin implant surgery

Chin implants are made from a variety of materials including silicone, other man-made materials (such as polythene) or tissue from your own body. The steps generally include:

• The medical practitioner makes an incision either on the underside of the chin or inside the mouth at the lower lip.
• If you are having surgery using your own tissue, this may be achieved by having the bone of your chin cut and moved forward, then secured with metal plates and screws.
• If your surgery involves a synthetic implant, the implant is put into position and the incision is closed

Potential complications of facial implant surgery

All surgery carries some degree of risk. Some of the potential complications of facial implant surgery include:

• allergic reaction to anaesthetic, which may be fatal
• heavy bleeding from the surgical site
• blood clots that may cause potentially fatal cardiovascular complications such as heart attack, deep vein thrombosis or stroke
• infection that may require treatment with antibiotics or further surgery in some cases
• allergic reaction to sutures, dressings or antiseptic solutions
• the formation of a large blood clot (haematoma) beneath the incision, which may require drainage
• keloids and hypertrophic scars – raised, thickened scars. These may form over the healed incision sites. They may be itchy and unsightly, but are not a threat to health
• temporary or permanent areas of numbness
• inflamed, itchy scars
• difficulty talking or smiling for several weeks
• movement of the implant, which will require further surgery
• slow healing, often related to smoking or diabetes
• short-term nausea following general anaesthesia
• reduced ability to move your mouth and lips.

Further surgery may be required to treat complications.

This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. Speak to your medical practitioner for more information.

Self-care after a facial implant operation

Your medical practitioner will provide you with post-operative care instructions, such as:

• how to care for your surgical site(s) after surgery
• medications to apply topically or take orally to aid healing and reduce the risk of infection
• specific instructions to look for at the surgical site(s) or in your general health
• when to follow up with your medical practitioner
• reporting any bleeding, severe pain or unusual symptoms to your medical practitioner.

Long-term outlook after facial implant surgery

The swelling may take a few weeks to reduce. You may not be able to see your new look for some months after the surgery. The effects should be subtle, but noticeable.

Implant results will be semi-permanent if human tissue is used because the tissue will age. The result will be permanent if synthetic implants such as silicone or polythene are used.

Alternatives to facial implants

There are no medical alternatives to facial implants that can reshape the cheeks or chin. Weight loss or weight gain, however, may change the shape of your face. Talking to a counsellor or psychologist may help you overcome your concerns about your appearance, and you may decide that you like yourself the way you are.

Where to get help

• Your GP (doctor)
• A psychologist, psychiatrist or counsellor
• A medical practitioner specially trained and experienced in performing facial implant surgery
• A second opinion from another medical practitioner specially trained and experienced in performing facial implant surgery
• Cosmetic surgery hub and hotline, Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 361 041
• Cosmetic surgery, Department of Health and Aged Care, Australian Government
• Private Hospitals Unit, Department of Health Email privatehospitals@health.vic.gov.au
• Australian Society of Plastic Surgeons Tel. (02) 9437 9200
• Royal Australasian College of SurgeonsTel. (03) 9249 1200
• Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 419 495