Facial implants can be very effective in treating conditions where the contour of facial bones adversely affects facial appearance. They are used in both cosmetic and reconstructive surgery (for example treating the affects of injury and congenital problems)
Implants can be used to augment all areas of the face including;
Cheeks (malar)
Chin
Mandibular angles
Infraorbital rim (beneath the eyes)
Pyriform fossa (around the base of the nose)
Forehead
Facial implants can either be preformed or can be custom made.
Preformed implants are made in an number of shapes and sizes by the manufacturer. The surgeon selects the most suitable size and shape at the time of the operation.
Custom-made implants individually made for each patient. They are usually generated using information from a CT scan and 3-D modelling technology.
Frequently Asked Questions
There are several materials commonly used in facial implants. They include Medpore, PEEK, titanium, polymethylmethacrylate, hydroxyapatite bone cements and silicone. Each of these materials has its own advantages and disadvantages. The best material to use depends on the specific problem.
Silicone
Silicone implants are occasionally useful in the cheeks and at the mandibular angles. They are difficult to fix to the facial bones and because of this can occasional move from the position where they were inserted.
Medpore
My preferred material for preformed implants is Medpore. Medpore is a biocompatible, porous polyethylene implant that can be readily shaved and adjusted during surgery. It is generally securely fixed to the facial bones with small detaining screws and so there is no risk implant movement after insertion. It is particularly good material for augmenting cheeks and the forehead. I occasionally also use it as a small in chin implant.
Titanium
Titanium is a very good material to skull reconstruction that has limited use in the face.
Hydroxyapatite Cements
Hydroxyapatite cements such as BoneSource can be used to fill small bony defects and build up small areas. It is not suitable for augmenting large areas of bone.
PEEK
PEEK (Polyether ether ketone) is a biocompatible plastic which is most commonly used in the construction of custom-made implants. The fact that the material can be shaped exactly into complex shapes makes it very effective in both reconstruction and aesthetic surgery
Surgery can be performed either under general anaesthetic or local anaesthetic with sedation. Most people can go home on the day of surgery although occasionally an overnight stay is required.
A small incision is made close to where the implant is to be placed and the implant is attached to the bone. Usually the implant is secured with several small titanium screws so that there is no chance of movement of the implant after the operation. Implants to the cheeks and lower jaw are often placed through incisions in the mouth. Incisions beneath the chin, at the angle of the jaw and in the lower eyelid are also occasionally used. Forehead and skull implants are usually placed through incisions within the hairline.
Antibiotics are usually given at the time of surgery and for 3 to 4 days afterwards to reduce the risk of infection. There is usually small amount of post-operative swelling, which persists for 1 to 2 weeks.
The placement of facial implants is usually very straightforward operation. There’s a small risk of infection and if this occurs the implant may have to be removed and replaced later after the infection has subsided.
