How Should I Revise These Temporal Implants?

Q: Dr. Eppley, I am a plastic surgeon in Canada. I have taken Dr Eppley’s implant courses. I have a case I wanted to ask Dr Eppley. I performed a male face and neck lift. At the time I placed temporal shell implants. The left implants migrated superior, and the right sits slight lateral. When should I revise this? What should be done differently at the time of a revision? Thank you for your help.

A:This is an initial pocket creation issue most likely. As a general rule they really don’t migrate superiorly…at least not in my experience. Under creation of the initial pocket is easy to do.  While a secondary pocket expansion can be done the real question is what is going to hold the implant down into the proper position in a soft tissue pocket where fixation of the implant is not usually possible?? It may work just by expanding the pocket but the definitive solution is an implant that has a bigger footprint than the original one.

Another option is to leave the implant where it is and fat graft around it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon