How Can Sagging After Cheek Implant Removal Be Prevented?

Q: Dr. Eppley, I am interested in cheek implant removal surgery.What techniques are used in Medpor removal to avoid any tissue sag? Does Medpor hinder the face returning to normal after removal.

A: Any cheek implant removal has the potential for a soft tissue sag thereafter, regardless of the material composition of the cheek implant. It is a simple function of tissue expansion of the overlying tissues and release of the soft tissue attachments. The likelihood of this happening in any cheek implant removal patient can not be precisely predicted and is a function of implant size, implant location and the patient’s inherent anatomy. This raises the question then of whether any type of cheek resuspension/tissue reattachment method should be done at the same time as their removal. This is not an easy decision and there is no method to accurately know if it is really needed. But I think one has to recognize that the face is not going to return completely to its preoperative state. (any more than removing breast implants will return the breasts exactly back to what they were before surgery to make a comparative tissue expansion analogy) If in doubt the best method is to do a soft tissue cheek resuspension through a remote temporal incision. The other more limited option is to use a bone anchoring method through the intraoral incision alone.

Dr. Barry Eppley

Indianapolis, Indiana