Are There Non-Silicone Cheek Implants?

Q: Dr. Eppley, I am writing because I have a quick question regarding cheek implants, which we had briefly discussed, vs fillers. I may have rheumatoid arthritis and I’ve heard that injectable fillers aren’t the best route with autoimmune disorders. I’m curious to know if cheekbone implants would be any better, and if you offer any that are non-silicone.  I would be grateful to read your thoughts on this topic.

A: The use of injectable fillers in patients with known autoimmune diseases is a bit of a mix bag. Historically the thought was that only collagen fillers should be avoided since they are a foreign collagen processed from a bovine source, hence the understandable apprehension when the body is injected by that material.  But more recent anectodal reports have come out that indicates even the very popular and well tolerated hyaluronic acid-based fillers may pose some concern. This has not been definitely proven and it may just represent the general ‘reactivity’ of the autoimmune patient to any stimulus, but the safest route would be to avoid any injectable fillers and lower the risk of that concern to zero.

This, of course, raises the question of whether any cheek implant, regardless of the material, might not pose the same risk…although they have not been to my knowledge in the medical literature or experience. Your concerns about silicone cheek implants is understandable although that feeling undoubtably comes from fluid-filled silicone breast implants of yesteryear and not solid preformed silicone facial implants. But alternative materials for cheek implants include PTFE-coated silicone, Medpor (porous polyethylene), pure PTFE and mersilene mesh. Whether these are all chemically and structurally different than silicone, whether one is better in the automimune patient is not known.

Dr. Barry Eppley

Indianapolis, Indiana