Zygomatic Implants through a Face-Lift Approach: Analysis of 30 Years' Experience.

[BACKGROUND] The use of zygomatic implants has been mostly replaced by fat grafting in rhytidectomy procedures. Furthermore, surgeons using implants prefer the intraoral approach. The authors aimed to describe and emphasize the usefulness of the preauricular approach as the best approach for this operation and underline the value of cheek implants as an alternative and/or as an adjunct to fat grafting during face-lift procedures for midfacial rejuvenation.

[METHODS] A retrospective study of 350 patients who underwent face-lift procedures with silicone malar implant placement through a preauricular approach was conducted. Postoperative photographs of all patients were examined by two physicians for postoperative volume adequacy, naturalness of appearance, and improvement in asymmetry. Patient satisfaction was evaluated using a questionnaire with an ordinal scale.

[RESULTS] The large majority of patients [338 of 350 (96.5 percent)] were completely satisfied or satisfied with the aesthetic outcome. The complication rate was very low and comparable to data reported in current literature.

[CONCLUSIONS] The application of cheek implants proved to be a great tool for midfacial volume rejuvenation with or without associated fat grafting. This conclusion was drawn from the answers reported in the questionnaires completed by the two examiners. The main challenge in this operation was the choice of the type, shape, and size of the implant. The preauricular approach should be given preference during this procedure because, compared to the other approaches, it is easier, faster, and more comfortable for both the patient and the surgeon.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.