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Risks, Complications & Contraindications

Unfortunately, all surgeries have risks and complications.  Complications can and do happen; these include allergic reaction to the anesthetic used, please see the Introduction to Anesthesia section for more information.  

Infection
You could develop a post-operative infection and need to have the implants removed, the infection dealt with and still have to wait for several months before an additional surgery can be performed to re-implant. Infections usually occur with the first few weeks. Some possible infections and a more common one being Staphylococcus, or simply Staph.  A more severe one is Methyl Resistant Staphylococcus aureus, or MRSA. This strain is a Methycillin-resistant "bug", but is not considered a "super bug" and is usually sensitive to at east 3 types of antibiotics. In itself it is very rare, much less with BA.

Be sure your thoroughly wash the face and neck area with an anti-bacterial soap such as Hibiclens or Anti-bacterial Dial for a few days before surgery.

Some patients are instructed to wash with these anti-bacterial soaps every day for 3 days beforehand. This precaution will assist in ridding the immediate area of Staph which naturally occurs on the skin.  Your surgeon will also "scrub" your face and neck with Betadine solution right before your incision is made.

Hematoma & Seroma
There is a risk of developing a hematoma [: a mass of usually clotted blood that forms in a tissue, organ, or body space as a result of a broken blood vessel ] or a seroma [: a collection of the watery portion of the blood of an animal which may need to be aspirated]

Implant Shifting (Displacement) & Asymmetry
There could be asymmetry due to malposition of the implant by the surgeon, swelling, trauma, hematoma, or general . There is also the risk of "shifting".  If this happens a second surgery may be needed to reposition the implant. 

Extended Loss of Sensation (Numbness)
Although you will be numb from the anesthetic and swelling -- as you heal various areas will regain sensation before others.  Remember that you are healing and to be patient.

Autoimmune Disorders Related To Silicone
There is no conclusive evidence with autoimmune disorders regarding silicone toxicity, rheumatoid arthritis, lupus, cystic fibrosis, fribromyalgia, etc..  Solid silicone facial implants have been used for decades in cosmetic, non-functional applications without any ill effects.

• Silica is silicon dioxide SiO₂, it occurs in a crystalline state, an amorphous (shapeless) state and in impure forms such as quartz, opal and sand, respectively. " In the form of silicates it is present in most natural water supplies. Typical concentrations lie between 1 and 30 mg/L. Higher concentrations may exist in brackish waters and brines. " (3) 

• Silicon is a "nonmetallic element that occurs combined as the most abundant element next to oxygen in the earth's crust and is used especially in alloys and electronic device" (Merriam-Webster). It may not BE a metal but it is considered semi-metallic. In other words, "Silicon doesn't occur in the free, elemental state, but is found in the form of silicon dioxide and complex silicates". It was "discovered" in 1824 by Jons Jacob Berzelius. "Silicon is important in plant and animal life. Diatoms in both fresh and salt water extract silica from the water to use as a component of their cell walls."(1)  Silicon is used in many household items such as transistors, micro chips and electronics. Hence, Silicon Valley - the computer capital. 

• Silicone is any of the [ :various polymeric organic silicon compounds obtained as oils, greases, or plastics and used especially for water-resistant and heat-resistant lubricants, varnishes, binders, and electric insulators] It is also found in processed foods, cosmetics, medications and all sorts of products that you are exposed to and ingest on a daily basis. It is also used to lubricate medical devices such as tubing, hypodermic needles and is found in the food industry as being used to lubricate blenders, frozen drink machines, piping, cooking utensils, and machines.

Silicones are synthetic polymers and are made by combining oxygen and silicon and in high temperatures and pressures can produce polydimethylsiloxane (PDMS). The fluids are made from linear chains of PDMS whereas the gels are lightly cross-linked to give it a thicker cohesive-ness.  The elastomer implant implants contain very little free PDMS so that it remains a solid. 

General Dissatisfaction
Also, there are the risks of it just not living up to what you expected.  To avoid this problem, choose your surgeon wisely. convey your desires, and remind yourself that you WILL be swollen for quite some times.  Some days, more so than others.

Contraindications
If you are in poor physical and/or emotional health or have unreasonable expectations, non-elastic skin previous existing medical conditions or bone disorders, you are probably not a good candidate for cheek augmentation surgery. 

You should not be or have not been on Accutane for the last 6 months. Accutane may cause Hyperostosis, an increased growth rate of bone matter.  Most often-affected areas are the hands, feet and face and increases your chances of keloid-like scarring from skin trauma (such as incisions).  

References
Merriam-Webster Dictionary
(3) APHA Standard Methods, 19th ed., p. 4-118, method 4500-Si D (1995).
ASTM D 859-94, Silica in Water.
EPA Methods for Chemical Analysis of Water and Wastes, method 370.1 (1983).
(4) Brown SL, Middleton MS, Berg WA, Soo MS, Pennello G. Prevalence of rupture of silicone gel breast implants in a population of women in Birmingham, Alabama. American Journal of Roentgenology 2000;175:1-8.