Facial Implant Material
Q: Dr. Eppley, in Europe and Australia, PEEK has recently come into use as a facial implant material, particularly being advertised for its ability to be custom manufactured/shaped for the patient.
One of the supposed benefits of this new material is that it is very similar in density and hardness to bone. However from reading your blog posts on Medpor vs silicone or ideas like titanium implants, it seems to me that this is irrelevant and that silicone remains both cheaper and easier for surgeons to use?
Would there be any advantage at all to this material or is it just a case of people trying to reinvent the wheel?
A: PEEK and any other firm rigid polymers as a facial implant material have a role to play in reconstructive surgery but not so much in the aesthetic patient for two primary reasons. First and foremost there is the surgical access needed to place the material. A rigid implant requires wide open incisional access or, at the least, longer incisions and a much bigger implant pocket. This is a major disadvantage over more flexible materials like silicone which can be placed through smaller incisions and then acquire the feel of bone when the backing on which they rest is bone. Secondly, custom designing of a PEEK implant is far more expensive than that of other materials like silicone often being 2X to 3X more expensive.
In conclusion, there are numerous other technical issues than can overtake whatever theoretical material advantages a facial implant material. (ease of placement and removal as well as cost being major considerations) While feeling ‘like bone’ may seem advantageous, that very material property is equally if not more potentially disadvantageous.
Dr. Barry Eppley