Treatment of Infected Facial Implants

Mohan, Kriti; Cox, Joshua; Dickey, Ryan M.; Gravina, Paula; Echo, Anthony; Izaddoost, Shayan A.; Nguyen, Anh H.

doi:10.1055/s-0036-1580727

Cited by 10 publications

(7 citation statements)

References 37 publications

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“…This inconsistency could be potentially explained by our finding that all 3 implant types demonstrate similarly low rates of these particular complications, which suggest that implant selection may not actually have an appreciable effect on clinical outcomes. In fact, prior studies have demonstrated that with regard to infections, other factors such as location of implantation 16 and preoperative implant biofilm seeding 18 may be more influential than the implant itself.…”

Section: Discussionmentioning

confidence: 99%

Complications Following Alloplastic Chin Augmentation

et al. 2023

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Background Alloplastic implantation has become a popular method of chin augmentation. Historically, silicone was the most commonly used implant, but porous materials have grown in favor due to improved fibrovascularization and stability. Nevertheless, it is unclear which implant type has the most favorable complication profile. This systematic review aims to compare the complications of published chin implants and surgical approaches to provide data-driven recommendations for optimizing chin augmentation outcomes. Methods The PubMed® database was queried on March 14, 2021. We selected studies reporting data on alloplastic chin augmentation excluding additional procedures such as osseous genioplasty, fat grafting, autologous grafting, and fillers. The following complications were extracted from each article: malposition, infection, extrusion, revision, removal, paresthesias, and asymmetry. Results Among the 39 articles analyzed, the year of publication ranged from 1982 to 2020; additionally, 31 were retrospective case series, 5 were retrospective cohort or comparative studies, 2 were case reports, and 1 was a prospective case series. More than 3104 patients were included. Among the 11 implants reported, the 3 implants with the highest number of publications were silicone, high-density porous polyethylene (HDPE), and expanded polytetrafluoroethylene (ePTFE). Silicone demonstrated the lowest rates of paresthesias (0.4%) compared to HDPE (20.1%, P < 0.01) and ePTFE (3.2%, P < 0.05). In contrast, there were no statistically significant differences in rates of implant malposition, infection, extrusion, revision, removal, or asymmetry when stratified by implant type. Various surgical approaches were also documented. Compared with subperiosteal implant placement, the dual-plane technique demonstrated higher rates of implant malposition (2.8% vs 0.5%, P < 0.04), revision (4.7% vs 1.0%, P < 0.001), and removal (4.7% vs 1.1%, P < 0.01), but a lower incidence of paresthesias (1.9% vs. 10.8%, P < 0.01). Compared with extraoral incisions, intraoral incisions resulted in higher rates of implant removal (1.5% vs 0.5%, P < 0.05) but lower rates of asymmetry (0.7% vs 7.5%, P < 0.01). Conclusion Silicone, HDPE, and ePTFE had low overall complication rates, demonstrating an acceptable safety profile regardless of implant selection. Surgical approach was found to significantly influence complications. Additional comparative studies on surgical approach while controlling for implant type would be beneficial for optimizing alloplastic chin augmentation practices.

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Section: Discussionmentioning

confidence: 99%

Complications Following Alloplastic Chin Augmentation

et al. 2023

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“…Although the customary treatment of implant-related infections previously looked towards prospective removal of the foreign body, conservative alternatives have more recently been favored. Such alternatives include wound debridement and localized delivery of targeted antibiotic therapy [5].…”

Section: Discussionmentioning

confidence: 99%

Imaging of Malar Silastic Implant Complications

Carfagno¹,

Ramos²,

Fierro³

et al. 2023

Cureus

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Facial cosmetic implants are utilized for definition enhancements in the malar, mandibular, and nasal regions. Though these implants are safe in the majority of patients, notable complications such as implant malpositioning may be seen. More rare but serious complications such as infection, abscess, and intrasinus migration may also occur, such as in this case reported on a 69-year-old female with a history of bilateral malar silicone implants. Imaging findings on this patient, whom initially presented with complaints of erythema and edema in the left malar region, were notable for edema and soft tissue signs of infection around a well-visualized crescent shaped maxillary implant. Penetration of the implant into the left maxillary sinus was also noted. Diagnostic imaging played a key role in determining the cause and severity of this patient's condition. Thus, the case reported is with an aim to familiarize radiologists with identifying and interpreting the complications of malar cosmetic implants on diagnostic imaging.

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“…A highly polished surface may discourage periosteum reattachment, whereas a very rough surface may encourage bacterial growth when contamination with saliva occurs. [ 15 ]…”

Section: Methodsmentioning

confidence: 99%

Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery

Mommaerts

2016

Ann Maxillofac Surg

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Context:Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing.Aims:The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting.Settings and Design:University hospital - prospective registry.Subjects and Methods:Twelve patients and 17 implantation sites were documented and prospectively registered. Malformational, deformational, and purely esthetic indications were encountered.Statistical Analysis Used:Descriptive.Results:Patient satisfaction was high, probably because the patients had input into the planned dimensions and shape. A serious infection with implant removal occurred in one patient who had six previous surgeries at the same sites. Technical and surgical guidelines were developed including splitting implants into two segments when the mental nerve was at risk, using a three-dimensional (3D) puzzle connection, providing at least two screw holes per segment, using scaffolds at the bony contact side, using a “satin” finish at the periosteal side, referring to anatomical structures where possible, making provisions for transbuccal and transoral fixation, using a high vestibular incision, and using a double-layer closure. Esthetic guidelines are discussed but could not be upgraded.Conclusions:Mirroring techniques and 3D print accuracy up to 0.1 mm allow precise planning of jaw angle implants. Patients are pleased when given preoperative renderings for their consideration. Infections can be managed using technical and operative recommendations and careful patient selection.

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Treatment of Infected Facial Implants

Cited by 10 publications

References 37 publications

Complications Following Alloplastic Chin Augmentation

Complications Following Alloplastic Chin Augmentation

Imaging of Malar Silastic Implant Complications

Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery

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