Implants in facial skeletal augmentation

Abstract

Facial augmentation using alloplastic implants remains a tried, tested, and true means of correcting skeletal insufficiencies and abnormalities. Thus, what was once old will be new again, and a renaissance in the use of facial implants will undoubtedly occur.

Solid Implants in Facial Plastic Surgery: Potential Complications and How to Prevent Them

“…4), and nerve hypesthesia/anesthesia. 4 Several studies have focused on complications of solid chin implants in particular, and were in agreement that one of the most common complications was dysesthesia secondary to manipulation of the mental nerves. This is seen in 20 to 30% of the patients, more often with anatomical implants and larger implants, and most patients have resolution of symptoms over several months.…”

“…Complications seen with midface implantation include inadequate correction or overcorrection, malposition, implant migration, infection, extrusion, nerve hypesthesia/anesthesia, and facial nerve injury. 4 For malar implants, the average infection rate is 2.4% and displacement rate is 2.3%. 8 In terms of orbital and periorbital implants, Rubin and Yaremchuk noted high rates of extrusion with smooth implants such as silicone (3.1%) and overall rates of infection and extrusion averaging 2.1 and 1.6%, respectively.…”

“…Midface augmentation is generally used to address volumetric deficiencies of the soft tissue and skeletal framework, such as malar hypoplasia, submalar soft-tissue insufficiency, or a combination of the two. 4 Nasal implants are used commonly for dorsal augmentation as well as correction of structural deficiencies and contour irregularities in primary Table 1 The most common causes of facial deformity requiring solid implant reconstruction…”

“…Mandibular augmentation is most frequently used for defects caused by microgenia or a poorly defined mandibular angle border. 4 Poor projection of the pogonion and soft-tissue inadequacy of prejowl sulcus can be corrected with the use of chin, extended chin, chin jowl, or prejowl implants. The mandibular angle region can also be augmented to more sharply define its borders or provide lateral enhancement using posterior mandibular angle implants.…”

“…Silicone is easier to remove because of its smooth surface, but this also predisposes it to migration. 7,8,17,19,21,22 Aesthetic failure Migration Infection Extrusion Mandible/chin 2,4,5,8,22,24 Inadequate correction or overcorrection…”