Do Custom Facial Implants Pose Limitations On Future More Superficial Cosmetic Facial Surgeries?

Q: Dr. Eppley, I had been perusing through your impressive website about cosmetic and reconstructive facial implants. Some of them seem rather large.

If you have time, would you be able to give me feedback on these topics that your plastic surgery website inspired?

1) For your larger complete mid-face “mask”, how do you secure each piece to minimize movement, migration and possible extrusion?

1.5) In the case of customized implants – for any part of the face – how is the height of each part of the implant measured to ensure that the lift or elevation afforded by the implant is optimal but also not too exaggerated. Is there a biometric baseline used? Every face is different; men and women, people of different ethnicity, people who are middle-aged or very advanced in age and some people are heavily affected by social media’s standards about what is trending or currently considered “hot” which means they have different facial surfaces and want different potential results. How does the customized implants production account for all these factors in determining the most ideal heights, surface relief, etc.? 

2) With such a large silicone implants, how does the inner skin tissue (above implant) and the bone underneath deal with this interruption in the strata of delicate tissues that the implant(s) now wedge between and the wedging encompasses a significant surface area? Even if a capsule is formed from the natural immune system trying to isolate this large foreign object, doesn’t the significance interruption between health inner skin and muscle/bone interface over a large surface  create other complications?

3) Do these large implants cause restrictions for future cosmetic facial procedures? Take the mid-face mask with or without cheekbones involvement in the implants. Would a future plastic surgery such as a deep plane face lift or rhinoplasty, for example, be made impossible to do or with severe compromised aesthetic results?

4) I read in several medical journals that the mid-face, especially the region where the cheeks meets the mid-nose and the piriform apertures – suffer the most wearing away of the bone with the natural aging process. It makes individuals in their 60s and 70s look very gaunt and deflated in the face. (But it’s natural, so I am not implying that Father Time is evil.) So if a man or woman gets anyone of your customized implants in these vulnerable areas, with time, wouldn’t the foundation on which the implants sit on be so fragile when the patient reaches age 70 or 80 that it might fracture the natural aged bone foundation underneath? The bone tissue thins out over time but the implant remains hard, unyielding and applying a downward force and tension/stress on the bone underneath.

Help educate me in the event I might invest in your artistic and technical precision at Eppley Plastic Surgery or just to help me because more information about these exciting elective procedures. If you do not have time, that’s okay. Any clarification or education will be warmly appreciated.

Thank you for your time.

A: In answer to your custom facial implant questions:

1) All facial implants are secured with titanium microscrews.

1.5)  The design of any custom facial implant is an artistic endeavor more than some scientific measurements which don’t exist for it. Experience is another major factor knowing the effects of a implant design to its external aesthetic effecvts.

2) It does not. It merely sits there passively.

3) They do not.

4)  That is not a risk. That theoretical biologic sequelae is not a reality.

Dr. Barry Eppley

World-Renowned Plastic Surgery