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The nose is the main point of focus for overall facial features from both the front and profile. A nose is flat, sunken in appearance will distract from your other facial features. Premaxillary augmentation addresses a sunken, drooped or pushed-in appearance of nasal base and the upper lip.

Who is a candidate for premaxillary augmentation?

If you have a nose appearance that makes you unhappy due to a sunken look, you are likely a candidate for this custom surgery. We will carefully measure and assess your lower face anatomy to ensure you achieve the desired results. Because a premaxillary augmentation will affectively lower the upper lip line, your lip position will be evaluated when relaxed, and when smiling.

A gummy smile…

In most cases, a premaxillary deficiency will show too much upper gum when smiling. This is normally corrected through the course of the surgical procedure. Every person has a unique situation, whether too much gum showing, or too little. A custom surgery can correct either of these aesthetic flaws.

Premaxillary Augmentation San Jose

What are the implants used for premaxillary augmentation?

Because everyone’s face “maps” differently – which is what gives you your unique looks – the exact techniques and implant material may vary from patient to patient. The general idea is to lift the base of the nose and bring it out farther from the face. To do this, various custom implants are available.


These are “autologous” (coming from your body) materials, usually cartilage and sometimes bone. Cartilage is often preferred because of its high biocompatibility and low rate of rejection or infection. Using autograft implants will extend the operating time because a separate procedure performed first to harvest the cartilage which may be taken from the septum.


These are materials that come from a tissue bank. While they can have good benefits for thin-skinned patients when combined with biomaterials derived from human skin, they also have a greater potential for reabsorption over time.


Because they are available as a medical graft, an advantage of using an allograft is that no addition surgery time is required, with no donor site recovery needed. While they are not necessarily as biocompatible as autographs, various versions of this type of implant have superior stabilization and rarely cause problems.

Other implants: Polymers, surgical-grade silicone, Gore-Tex and powdered ceramic (hydroxyapatite) are other implant possibilities.

We list these different types of implant materials only to show you that there are many ways to tailor your procedure to your specific needs and anatomy. During your consultation, we will detail exactly what procedure we recommend and why we feel it will give you an optimal, very attractive outcome.

Your best choice: Cheng Plastic Surgery

Dr. Elbert Cheng and Dr. Jacqueline Cheng are highly accredited facial plastic and reconstructive surgeons with double board certification in head and neck surgery, with a private clinic in Saratoga, California, easily accessed from San Jose and Palo Alto and across the Bay Area. They have established a luxury, private, state-of-the art surgery center and a full staff of medical professionals to assist you.

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Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at (408) 741-9982.

Practice Policy Update from Cheng Plastic Surgery Regarding COVID-19 View Update Virtual Consultation

Practice Policy Update Regarding COVID-19

Monday, January 4, 2021:

We are open!

We cannot wait to see all of our amazing patients in our office! We are currently working with a more limited schedule than before, so please be patient as we navigate through this, together.

There are a few key changes we’ve made to our appointment protocol to ensure we are maintaining social distancing and following strict COVID-19 health and safety protocols - for you AND for us.

  1. Call our office from your car once you’ve arrived for your appointment. A staff member will come out to greet you, take your temperature and conduct a short COVID-19 health screening to make sure you are in good health prior to entering the building. Our doors will remain locked during normal business hours to ensure only those who have been screened can enter.
  2. Please arrive at your appointment wearing a mask or protective face covering. We will not be able to bring you inside the office without one.
  3. We will not have more than one patient in the lobby at a time.
  4. You will be greeted by Dr. Elbert or Dr. Jacqueline wearing their Personal Protective Equipment deemed necessary by your specific treatment. (N95 mask, gloves, face shield or protective eyewear, etc.) We ask that you leave your mask on during the procedure, and only take it off if necessary to complete the treatment.
  5. All necessary transactions will be done in the room your treatment is being performed. This will avoid unnecessary back ups in the lobby.
  6. You will then be walked out through the back door of the office. This is the best way to keep all staff and patients socially distanced while maintaining one steady flow of traffic throughout the building.

And of course, all rooms will be heavily disinfected immediately after you leave just as we have always done prior to the pandemic. Each room is equipped with an air filter as an added safety measure. We will place a major focus on high-contact areas such as chairs, doorknobs, counter tops, mirrors and more.

We are still continuing to conduct Virtual Consultations if you prefer a quicker and no-contact experience.

Virtual Consultation

For the safety of our patients and staff, we ask that you reschedule your appointment and do not enter our office with any of the following conditions:

  1. You have tested positive for COVID-19 in the last 14 days.
  2. You have been in close contact with someone who has tested positive for COVID-19 in the last 14 days.
  3. You traveled more than 150 miles or have been in close contact with someone who has traveled in the last 10 days.
  4. You are experiencing any of the following symptoms:
    • fever or chills
    • cough
    • shortness of breath
    • fatigue
    • muscle or body aches
    • headaches
    • sore throat
    • loss of taste or smell
    • nausea, diarrhea, or vomiting

Concerned about getting the Moderna vaccine after having recently received filler treatment? In some studies, it has been observed that a small percentage of the vaccinated groups experienced localized inflammation (swelling) after receiving the Moderna COVID-19 Vaccine. In said cases, all studied reactions were temporary immune responses. It has been suggested that patients refrain from getting filler two weeks before and after the vaccine. If you have any questions, please feel free to call our office!

Thank you for your continued support and we can't wait to see you again!

Kindest Regards,,

Dr. Elbert, Dr. Jacqueline and staff at Cheng Plastic Surgery

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