Q: Dr. Eppley, I had a medpor implant 3 years ago. I had a heavy infection 2 weeks after the surgery that cured by antibiotics. I have also had 2 more small infections during last 3 years which all happened in the right side of my implant. Now there is no infection. Finally after a CT the doctors noticed that the right side wing is too big and irritate my mouth tissue in that spot. Now you can see a tiny white spot there that doctors say that is my implant showing off!!! I do not want to remove it. I like the shape and I am totally afraid of removing it and having wait for 6 months to replace it. Is there any possibility of just fixing the right side by surgery and not removing it? I do not have access to my original surgeon who did it and I need to fix it with another doctor. Please help me!
A: You did not say what facial location was implanted. I will assume since you mentioned that it has sides that it is either cheek or jaw angle implants. Given that you are a female I will also assume that these are cheek implants. With both acute and chronic infections of the implant, and perhaps even a large size, the overlying soft tissue coverage of the implant has thinned resulting in implant exposure. Usually when this happens the fate of the current indwelling implant is sealed and the need to remove it likely. You wanting to keep the implants is understandable given your current investment into them. One option is to simply cut back the exposed portion of the implant sufficiently to allow soft tissue closure over it. In so doing you have to realize that healing over the implant is not assured and that the risk of failure with this approach is high. But you have little to lose by so doing other than the operative experience and cost and in some cases it may be successful. If this should fail then you have done all that is possible to salvage the exposed facial implant.
Dr. Barry Eppley