Can PMM Cheek And Chin Implants Be Removed?

Q: Dr. Eppley, I had PMMA cheek and chin implants placed 6 years ago. I’m looking to go the custom route now to address the asymmetry caused by the implants. As such, I have a couple of questions:

– Can the PMMA implants be removed easily without damaging soft tissue?

– Will the existing implants make it impossible for new implants to be designed? Do they have to be removed first?

Thank you!

A: In answer to your facial implant questions:

1) Since the bone nor the soft tissue bonds directly to PMMA their removal should be successfully done. However whether there is bone overgrowth on them, or more importantly, bone resorption under them (most relevant to the cheeks in which there may be maxillary sinus exposure on their removal) it would be important to know what the surrounding bone looks like by a preoperative 3D CT scan.

2) As a general rule I don’t find the need to first remove any facial implants for either custom facial implant designing or their placement. But the need for a preoperative 3D CT scan remains to have more insight into the indwelling implants and the tissue reactions around them.

Dr. Barry Eppley

Indianapolis, Indiana