Can Medpor Facial Implants Be Removed?

Q: Do paranasal implants any effect on the length of the upper lip? Do they lengthen the upper lip, what is common with premaxillary implants, or do the paranasal implants rather lift the upper lip a little bit? In one of your You Tube videos about Advanta PTFE facial implants you soaked these implants in an antibiotic solution before they are implanted. Would you similarly dip the Medpor implants in a antibiotic solution also? I noticed that you use both implant materials – silicone and Medpor – and you obviously know the advantages and disadvantages of both very well. I personally would prefer the Medpor implants because they permit tissue ingrowth. But I often hear that Medpor implants are virtually unremovable once they are incorporated. Have you ever removed an incorporated Medpor implant? Is it true that it is extremely difficult to separate the periosteum from the surface of an incorporated Medpor implant?

A: Paranasal implants will not lengthen or push the lip down like a premaxillary implant. Neither will they lift the upper lip either. They merely provide fullness to the nasal base.

I soak all implanted materials in an antibiotic solution. This is particularly valuable in porous implants where bacteria can become trapped into the pores of the implant and not easily washed or rubbed off. The porous nature of the Medpor material also allows an antibiotic solution to be impregnated into the implant with vacuum infiltration or prolonged soaking.

Tissue incorporation into a facial implant is a two-edged sword. It has a benefit of providing anchoring of the implant to the bone site through tissue fixationalthough that advantage can be gained by screw fixation at the time of placement. Removal is definitely more difficult but by no means impossible, particularly for a small anteriorly located implant under the nose. It is more tedious and more tissue disruption must be done to get them out but it is not that difficult.

Dr. Barry Eppley

Indianapolis Indiana