Q: Dr. Eppley, five years ago I got Medpor malar implants. I am very happy with my cheek implants that provide me with very high and prominent cheek bones – a look that I have always wanted. I also like the fact that they integrate with my own tissue. But recently I have read this on the internet:
“Explantation of nonsilicone facial implants that have integrated into the surrounding tissues can be very difficult to remove, and in some cases it can contribute to nerve injuries. Any implant, regardless of material, can produce nerve injuries if a portion of the implant is in direct contact with a main branch of the sensory nerve.”
I know that one wing of the malar implants is directly below the foramen infraorbitale, where the infraorbitalis nerve comes out of the bone. Now I am worried that I could get serious nerve damage if the implant should have to be removed for a medical indication in future. What is your experience with explantation of Medpor malar implants and the risk of permanent nerve damage? Does this nerve stick to the Medpor implants?
A: While your concerns are understandable, you are worrying about a problem that you do not have and are very unlikely to ever get. Unless you now have infraorbital nerve symptoms (pain and/or numbness), your implants are not impinging on the infraorbital nerves and are not even that close to them. Thus, if you ever should need the implants removed, they should be able to be explanted without nerve injury. While Medpor facial implants are frequently stated to be very difficult and destructive to remove, that has not been my experience.
Dr. Barry Eppley