What Are the Risks of Zygomatic Augmentation?

Genioplasty and malar augmentation—commonly referred to as cheekbone enhancement surgery—are increasingly sought for facial contouring and aesthetic refinement. While generally safe when performed by qualified craniofacial or plastic surgeons, the procedure carries several well-documented risks that patients must understand before consenting.

Immediate perioperative complications may include hematoma formation, infection at the incision or implant site, and transient or persistent sensory changes—particularly in the distribution of the infraorbital nerve, which can result in numbness or altered sensation over the cheek, upper lip, or lateral nose. Swelling and bruising are expected but typically resolve within one to two weeks.

Implant-related concerns include malposition, palpability, extrusion, or capsular contracture—especially with non-integrated alloplastic materials such as silicone or porous polyethylene (Medpor). Bone resorption beneath the implant has been reported with prolonged mechanical pressure, particularly when oversized or improperly contoured devices are used. In rare cases, implant migration or asymmetry may necessitate revision surgery.

Long-term considerations encompass aesthetic dissatisfaction due to overcorrection, undercorrection, or unnatural contour transitions—often stemming from inadequate preoperative planning or insufficient three-dimensional imaging analysis. Patients with thin soft-tissue envelopes or compromised vascularity (e.g., smokers or those with uncontrolled diabetes) face elevated risks of wound dehiscence, delayed healing, and implant exposure.

As with any elective cosmetic procedure, thorough patient evaluation—including medical history, psychological screening, realistic expectation setting, and discussion of alternatives such as autologous fat grafting or structural dermal fillers—is essential to mitigate risk and optimize outcomes.