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At the American Academy of Facial Plastic and Reconstructive Surgery meeting in Washington, DC, September 23, 1988, William J. Binder, Los Angeles, Calif, presented his experience with submalar augmentation.
Dr Binder reported that the youthful face is really characterized by fullness of the cheeks. He based this observation on histologic studies showing that the anterior cheek has a high amount of adipose tissue that camouflages skeletal deficiencies. With age, gravity causes shifting of adipose tissue, and atrophy of adipose tissue and decrease in coverage of the skeletal structures of the midface develop.
Dr Binder has performed submalar augmentation on 125 patients for a total of 248 procedures over a period of 6 years. The Silastic implants are placed via a Caldwell-Luc approach on the anterior face of the maxilla and not along the zygomatic arch, where cheek malar implants have been routinely placed. These patients had eight minor complications (asymmetry
Submalar Augmentation. Arch Otolaryngol Head Neck Surg. 1989;115(6):663. doi:10.1001/archotol.1989.01860300017007