Real Questions About Facial Implants, Answered

Real people ask these questions every day on forums like RealSelf. We pulled the ones that come up again and again — and answered them here, honestly.

Jaw (9) Chin (8) Cheek (10) Brow / Forehead (4) PEEK & Materials (8)

Jaw Implant Questions

Can a jaw implant be made from my own bone instead of a synthetic material?

If the implant is small enough, it is possible to use a bone graft from the hip or skull. However, this would require a second surgical site, result in additional scarring, and lead to a longer recovery time.

PEEK/DMI implants are designed to mimic the composition of natural bone. As a result, PEEK/DMI implants are considered to be a safer and more effective option for jaw implants.

Will people be able to tell I have a jaw implant?

A well-designed, properly placed jaw implant should read as your bone structure, not as “surgery.” Because our implants are modeled from your own CBCT scan rather than trimmed from a stock shape, the transition into your natural jawline is built into the design from the start.

What's the difference between jaw implants, jaw surgery, and fillers for a sharper jawline?

Fillers are temporary and limited in how much structural change they can create. Jaw surgery repositions the bone itself, typically for bite as well as shape. A custom jaw implant adds engineered volume and angle to the jaw you already have, without moving the bone — a middle path for a defined jawline without full skeletal repositioning. See when jaw implants make sense, or explore masculinizing jaw and chin implants for a stronger jawline.

Which lasts longer — silicone, titanium, or PEEK/DMI jaw implants?

All three are considered long-term options when properly placed. The bigger factor in longevity is fit and stability, not just the raw material — which is why we mill each implant to sit precisely on your bone rather than relying on a stock size that’s been trimmed down.

I have a narrow, long face — can a jaw implant help?

The narrowness in your jaw can vary depending on its origin. Since every design begins with a detailed study of your face and your CBCT scan, we can accurately identify the specific areas that are narrow—such as the jaw angle, ramus, and chin width. This allows us to create a custom implant that targets these precise areas instead of using a generic “wider jaw” shape.

Can a jaw implant fix mild asymmetry?

Yes — this is one of the strongest cases for a custom-designed implant over a stock one, since we can design the left and right sides differently to balance an asymmetry, something a standard S/M/L implant can’t do.

Do jaw and chin implants need to be replaced eventually, like breast implants?

No — unlike breast implants, facial implants don’t have a scheduled replacement. A well-fitted custom implant is designed to be a one-time placement.

How much does a custom jaw and chin implant cost?

Pricing depends heavily on case complexity and whether you’re combining multiple areas in a single surgery. We avoid giving a generic flat rate upfront because a precise quote only makes sense once we’ve had a consultation and fully understand exactly what we’re doing for you. Read a real patient’s implant journey for a sense of the process before your consultation.

I have a rounder face and want more jaw definition — is an implant even the right procedure for me?

A rounder face can have different root causes. Sometimes it’s about the jaw angle and projection—which falls into implant territory—and other times it’s more related to soft tissue or facial fat, where an implant wouldn’t be the right solution at all. That’s why we never assume a one‑size‑fits‑all answer. Instead, we start with a thorough study of your face and a CBCT scan, so we can tell you precisely which category you’re in and what approach actually makes sense for you.

Chin Implant Questions

What if my chin implant looks crooked or asymmetric after surgery?

This issue typically occurs with generic implants. Should it happen with a custom implant, it would point to a placement issue rather than a design flaw—and a revision can usually correct it. Because our implants are custom‑designed in close collaboration with your surgeon before manufacturing, we map out both the shape and the precise position in advance, which significantly minimizes guesswork during surgery.

Can a chin implant fix my profile without also doing jaw surgery?

Sometimes. It depends on whether your concern is primarily chin projection or width (which an implant addresses well) versus a true bite or jaw-position issue (which needs surgical repositioning). We map this during your imaging review before recommending an implant-only plan.

Do chin implants feel and move naturally once healed?

A properly sized and placed implant shouldn’t feel like a separate object once healed — it becomes part of the contour under the soft tissue. Oversized implants relative to your tissue are the most common cause of an “implant-y” feel, part of why we size to your actual scan rather than a generic S/M/L option.

What happens to the area if I remove my chin implant later?

If you remove a chin implant later on, some patients notice mild soft tissue changes afterward—such as slight laxity or contour irregularity—especially if the implant has been in place for a long time. This is more commonly associated with generic, off-the-shelf implants. If you’re considering removal or revision, we will take new scans to evaluate your current anatomy and map out what the area will look like afterward, so we can plan accordingly.

How do I know if I need a chin implant alone or a full genioplasty?

This comes down to whether your chin needs added projection or width (implant) or repositioning (genioplasty, which moves the bone itself). Your CBCT scan shows the actual bone relationships, so this isn’t a guess — we can tell you which category your case falls into before recommending anything.

My chin implant caused numbness or lip pulling — is that permanent?

Numbness or lip pulling after chin implant surgery can stem from several factors, most commonly nerve irritation, compression, or an incision that extends further than necessary. The implant material itself also plays an important role—surrounding tissue may either accept it naturally and integrate well, or it may mount a persistent reaction over time.

As for permanency: mild nerve irritation often improves gradually over weeks to months. However, if the nerve has been significantly stretched or damaged, or if a chronic tissue reaction develops, symptoms could last longer. A thorough in-person evaluation would be needed to determine the specific cause and realistic recovery timeline in your case.

Can a chin implant be removed and replaced in the same procedure?

Often yes, but it depends on scar tissue, whether there’s any infection present, and what you’re switching to. If you’re changing materials or getting a custom design in place of a stock implant, we’d want new imaging first so the replacement is planned, not just swapped in.

My decades-old chin implant just got infected — does that mean the material failed?

Not necessarily. Late infections often trace back to an unrelated event — dental work, trauma, or bacteria reaching the implant some other way — rather than the material breaking down after years of being fine. Any late infection is worth an evaluation rather than a guess about cause.

Brow / Forehead Implant Questions

Can a brow implant reduce a heavy, prominent brow ridge?

This is one of the more common requests we see, especially in facial feminization work. A custom design (or, in reduction cases, contouring rather than adding volume) is planned from your CBCT scan to soften the ridge without over-flattening it.

Is a browbone implant safe near the eyes and sinuses?

The brow/forehead area sits close to the frontal sinus, which is exactly why imaging matters so much here — your CBCT scan shows your sinus anatomy before any design work happens, so the plan accounts for it rather than discovering it in surgery.

What's the difference between a brow implant and forehead contouring surgery?

Contouring surgery reduces or reshapes existing bone. An implant adds a designed structure rather than removing material. Many complete forehead plans combine both, depending on whether you need reduction, augmentation, or both in different areas.

Will a brow implant look natural in profile and under makeup?

That’s precisely what the 3D design review is for. Before manufacturing, you and your surgical team will examine the digital model from every angle—including the profile view—so any potential concerns can be identified and addressed well ahead of surgery.

Cheek Implant Questions

What are the real pros and cons of cheek implants?

Pros: a permanent, structural change to cheek volume and projection with no ongoing maintenance like filler needs. Cons: it’s a surgical procedure with real risks — infection and possible revision if you’re unhappy with size. We walk through both sides honestly, not just the upside.

Will a cheek implant be visible or show through my skin?

Properly sized implants sit deep, directly on the bone under muscle and fat, so the edge shouldn’t be visible or palpable in most patients. The main risk factor is an oversized implant on a very thin face — exactly the kind of mismatch custom, scan-based sizing is designed to avoid. See real results in our cheek implant case story.

Cheek implants vs. fillers vs. fat transfer — what's actually different?

Filler and fat transfer add soft-tissue volume and are temporary or semi-permanent; lower commitment, but need to be repeated. A cheek implant is a permanent structural addition — a bigger decision, but a one-time one for the right candidate.

How long until cheeks look normal after implant surgery?

Initial swelling typically peaks in the first few days, but the final contour can take several months to fully settle. We talk through a realistic timeline for your specific case rather than a generic “two weeks and you’re done” answer.

Can a cheek implant be removed later without sagging?

It’s possible, but the likelihood of visible change depends on how long the implant was in place and how much surrounding tissue adapted to it. This is a conversation we have honestly before placing any implant — not every decision is fully reversible.

Will cheek implants make a future facelift harder?

It depends on the approach used to place them. An intraoral (inside-the-mouth) placement generally interferes less with a later facelift than a more superficial approach — one more reason surgical approach matters as much as material choice.

Can cheek implants be removed without full general anesthesia?

It depends on depth, scar tissue, and how the original implant was placed. Many removals are done under IV sedation rather than general anesthesia, but this is genuinely case-by-case — something to map out directly with your surgeon rather than assume either way.

Should cheek implants and rhinoplasty be done together or separately?

Both approaches are common. Combining them can mean one recovery instead of two, but swelling from one area can sometimes make it harder to judge the other’s result right away. We map the sequencing during joint surgical planning based on your specific goals for each area.

My implant felt like it slipped right after surgery — is that common?

Early movement is uncommon with a custom, model-planned implant because the pocket size and fixation are mapped out in advance — but any implant surgery carries some risk of shifting in the first weeks while tissue settles. If something feels off early, that’s worth flagging to your surgeon right away rather than waiting.

I'm in my late 40s with volume loss from aging — am I still a good candidate for cheek implants?

Yes — age-related volume loss is actually one of the more common, valid reasons people come to us for cheek implants, not a barrier. The same CBCT-based design process applies regardless of age; what matters is your current bone structure and soft tissue, not a cutoff birthday.

PEEK & Materials Implant Questions

Isn't PEEK just a more expensive version of silicone with no real benefit?

That’s a fair objection. You’ll find some surgeons online arguing that standard PEEK offers no real biologic advantage over silicone—and for traditional PEEK, that criticism does hold some truth.

However, we don’t use traditional PEEK. Our material is PEEK/DMI, which incorporates hydroxyapatite directly into its matrix and is specifically engineered to encourage bone‑like integration with surrounding tissue. Additionally, it undergoes a surface treatment that promotes cell attachment, making it hydrophilic rather than hydrophobic. The result is a material whose composition closely mirrors that of your own natural bone.

What is hydroxyapatite, and why combine it with PEEK?

Hydroxyapatite is a mineral that constitutes a major portion of natural bone. By integrating it with PEEK, we give the implant surface characteristics that more closely resemble real bone—rather than leaving an inert plastic simply resting against your tissue. PEEK alone provides the necessary strength and CAD-millability; hydroxyapatite is added to promote bone‑like biological interaction, complemented by a surface treatment that enhances cell attachment and hydrophilicity.

Does PEEK integrate with bone the way natural bone does?

Plain PEEK is largely inert and does not integrate with bone. That’s specifically the gap our PEEK/DMI composite approach is designed to address — rather than relying on PEEK alone, we treat the implant surface to promote a more bone-like relationship with the surrounding tissue.

Is a custom PEEK implant actually worth the added cost over standard silicone?

Silicone carries well-documented risks, including bone erosion and other long-term complications, so it rarely proves to be a cost-effective choice over time. Custom PEEK/DMI justifies its cost when you need precise, patient-specific shaping—whether for asymmetry correction, complex contouring, or larger structural changes. In those cases, a generic implant with hand-trimming simply falls short, particularly when long-term security and tissue integration are priorities.

Does PEEK cause more infections than other implant materials?

Published rates for porous facial implants generally run in the roughly 5–12% range, and the biggest single predictor of infection is contamination during handling and surgery — not simply which base material was chosen. Surgical protocol matters as much as material selection.

Does PEEK/DMI feel more like real bone than titanium or silicone?

Mechanically, PEEK/DMI has a stiffness closer to that of natural bone than titanium does—which is precisely why it’s used in load-bearing craniofacial implants. The addition of hydroxyapatite and specialized surface treatments is intended to take this a step further, encouraging true tissue integration rather than simply matching bone’s physical properties. For the full technical breakdown, see our PEEK vs. DMI materials guide.

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THE HIDDEN RISK

The Hidden Flaw Inside Every Standard PEEK Implant

Biocompatible only means a material passes three narrow tests: no cytotoxicity, no significant acute inflammatory response, and chemical stability in tissue. We don’t treat that as the finish line, because none of it is the same as functional integration. Standard PEEK, like solid silicone, is bio-inert: the body responds to it by building a fibrous capsule around it. That capsule is not integration. It is defensive isolation.

Structurally, that capsule creates a mechanically weak interface, a potential sliding plane, and a biological barrier between the implant and the bone. And that interface is never static—it is subject to cyclic chewing loads, constant muscle activity, repetitive microimpacts, and the bone’s own adaptive changes. Without direct integration, the system never reaches primary structural stability: the bone never forms a direct union, and the soft tissue never forms a functional seal.

The real problem isn’t micromovement itself. It is the absence of structural integration that allows physiological load transmission. Left uncorrected, this can progress from healthy bone resorption—a normal, adaptive process—into mechanical erosion: a pathological, progressive, and largely irreversible loss of bone driven by sustained pressure and friction against an implant that was never built to fuse with it. This is not unique to one brand of PEEK, and it is not a rare complication. It is a documented, mechanical consequence of any bio-inert material—standard PEEK, silicone, or porous polyethylene—that is not engineered to integrate with living bone. It is precisely why we do not manufacture standard PEEK implants.

THE END OF THE FOREIGN OBJECT

DMI: The Only Implant Material We Manufacture

DMI (Direct Molecular Integration) implants are not simply another PEEK product—they are a fundamental reimagining of the implant as a biological scaffold. We modify the PEEK matrix with hydroxyapatite (HA), a mineral chemically similar to bone itself, which increases surface energy, encourages osteoblasts to adhere directly to the implant, and reduces fibrous capsule formation. Every implant we manufacture uses this dual-interface design: bone that fuses directly to the implant, and soft tissue that adheres to it just as directly—sealing the mechanically weak gap that standard PEEK leaves behind.

Osseointegration (Skeletal Lock)

Hydroxyapatite in our implants' engineered surface encourages the patient's own bone cells to grow directly into its matrix, creating a fused, load-bearing bond rather than an implant that simply rests against the bone.

Soft-Tissue Integration (Mechanical Lock)

Collagen and fibroblasts weave directly into the implant's surface, forming a natural seal instead of the slippery scar-tissue capsule that surrounds a bio-inert implant.

Lower Infection & Biofilm Risk

The engineered surface is designed to inhibit biofilm formation, one of the primary drivers of implant-related infection and rejection.

THE CHOICE

Standard PEEK vs. DMI Bone & Tissue Fusing Implants

Standard PEEK (Not What We Manufacture)

Bio-inert—tolerated by the body, never fused with it
Isolated by a fibrous scar-tissue capsule—a hidden, unintegrated gap
Rests against bone instead of fusing to it
Fibrous capsule creates a mechanically weak, unstable interface
Prone to micromovement and progressive bone erosion over time
A space-filler, not a living part of the patient’s anatomy

DMI Bone & Tissue Fusing Implants (Our Only Standard)

Bio-active surface technology enhanced with hydroxyapatite
True osseointegration—bone fuses directly into the implant matrix
Soft tissue integrates to form a natural, sealed barrier
~30% less post-operative swelling in comparative data
Engineered to inhibit biofilm formation and reduce infection/rejection risk