Do Silicone Temporal Implants Behave Like Silicone Implants In The Nose?
Q: Dr. Eppley, In considering getting temple implants for augmentation, I have read some bad reviews about the use of silicone. I realize that these talk about their use in rhinoplasty. It was stated that silicone had a higher chance to shift and possibly become “rejected” by the body. I had read that Gore-tex enables the tissues to grow “into” it so it was less likely to switch or protrude months or years later. How does this relate to implants in the temple region. Also, I have attached an overview of the temporal augmentation procedure written by a doctor. He talks a lot about risks and complications. He makes it sound like it is a bad procedure. What do you think?
A: What potentially can happen to an implant on the nose has no correlation at all to what occurs in the temples. They are two different anatomic sites. In the nose the implant is only covered by thin skin and has potential to be exposed to the contaminated nasal airway and is, in fact, placed by being directly exposed to nasal air and the nasal linings. In the temples, the skin and fat cover is very thick and the implant is placed deep under the fascia and right up against well vascularized muscle. What can happen to an implant in these two anatomic sites is dramatically different when it comes to risk. They are not remotely comparable.
Neither Silicone nor Gore-Tex material will have tissue ingrowth. They both simply become encapsulated as they are smooth-surfaced materials.
When reading the ‘Risks of Temporal Augmentation’ summary that you sent me that was obviously written from a perspective of having never done a more contemporary method of temporal augmentation and has no craniofacial plastic surgery background/experience. It is written based on an old style way of a big coronal incision and placing some type of material under the temporalis muscle. That might be more relevant to a large temporal defect that occurs from a craniotomy but not a cosmetic temporal augmentation.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.