Can My Medpor Cheek Implant Asymmetry be Fixed with A New Custom Implant Design?

Q: Dr. Eppley, I am interested in a consultation for a unilateral cheekbone implant revision. I currently have Medpor cheek implants on both sides. I am very happy with the appearance of one side, but the other side has a visible asymmetry in size/projection that I would like to correct. In the photos I am sending, there is an image with a red arrow pointing toward the cheekbone area I would like to fix. That side is the one I would like to improve so that it more closely matches the other cheekbone, which I am very satisfied with. What I am hoping to achieve is: • Removal of the current Medpor implant on the problematic side • Replacement with a custom 3D-designed implant that is mirrored from the “good” side so that both cheekbones match as closely as possible.

A:Thank you for your inquiry on secondary cheek implants surgery. When you have asymmetry and bilateral facial implants, such as cheek implants, that typically occurs due to placement differences, natural bony asymmetry differences between the two sides or some combination thereof. Thus you are correct in that the ideal approach is to make a 3-D design based on the good side to be placed on the undesired side. The problem with this approach with Medpor material is that it simply is almost never seen on a 3-D CT scan and even if it is visualized only part of the implant usually appears. Only in very rare circumstances, and I have seen thousands of 3-D CT scans with the implants on them, is a Medpor implant ever really adequately seen. Thus this throws a wrench into the best way to treat your cheek implant asymmetry.

There are alternative strategies to this ideal plan to treat your cheek implants asymmetry but these or not is optimal as the 3-D mirrored approach. But before delving into what the less than ideal treatment optiokns are it is reasonable to first get a 3-D CT scan to be certain that these other less than ideal approaches may need to be considered.

Dr. Barry Eppley

World-Renowned Plastic Surgeon