The Face Lift of The ’90s

Longevity – May, 1990

Perhaps the most interesting and innovative of the new facial implants is the submalar, or under-the-cheekbone implant, created by William J. Binder, MD, a Los Angeles facial and reconstructive plastic surgeon and clinical faculty member of surgery at UCLA. “As many of us age, our faces thin out and become sunken. It’s that Abe Lincoln look.”

Just pulling skin tight over the hollows of the cheeks didn’t solve this, but he reasoned that putting a small implant just below the cheekbones would fill out those depressions, lifting up the middle third of the face and reducing the folds and lines around the mouth.

For seven years, beginning in 1982, Binder worked to perfect his thin implants made of Silastic, a nonporous silicone extremely resistant to infection. In 1988, he introduced his surgical technique and four standardized implants to his colleagues. Since then, some 600 surgeons across the US have used the implants.

Because the procedure is simple and relatively inexpensive, submalar augmentation may soon become common. The surgery can be performed in the doctor’s office, under local anesthesia, in about 40 minutes. The implants stay put, Binder says, because facial tissue almost immediately envelops them. Many of the surgeons using the FDA-approved Binder implant are trying them on patients between ages 38 and 50, many of whom are hoping to delay a face lift. But Binder says the implant can provide a subtle, high-cheekbone effect in younger patients as well. “For others, the implant balanced the features,” says Binder. “If you have a strong nose and jaw but weak cheekbones, this procedure can, with little pain and virtually no complications, give the face a rounder, softer look.” He believes that his submalar implant will become a regular component of face lift surgery. “If you have great bones to begin with and a good surgeon,” he says, “a face lift alone will probably make you very happy. But a patient with poor bone structure, flat cheekbones and flat midfacial structure will get a poor result that won’t last very long. Using this implant, particularly in tandem with a chin implant, can provide a better underlying structure on which to perform the face lift.” Binder claims that in eight years of performing this procedure, he has had no permanent complications and only two minor infections; and though the surgery can be reversed, he has never had to remove an implant.

“This implant surgery,” he says “to me is the essence of elective cosmetic surgery-that is, doing the least amount to accomplish a significant result with little risk.”