What Is The Best Facial Implant Material If I Want To Box After Surgery?

Q: Dr. Eppley,  I am researching the best options for facial implants and have a couple of questions regarding material suitability and safety:

Given that PEEK has a smaller elastic modulus mismatch compared to bone than titanium, does this make PEEK implants a better choice for reducing risks associated with stress shielding?

If I were to choose titanium facial implants, would it be safe to participate in high-impact sports such as boxing, or does the rigidity of titanium make it too dangerous in cases of facial trauma?

Thank you for your insights and expertise on this matter. I look forward to hearing your thoughts.

A: You are overlooking the most important features of any facial implant material….how easy is it to place and subsequently remove/modify/replace. Given that the revision of all facial implants is in the 30% to 40% range this implant feature becomes the most important material feature.

Your biomechanical analysis of rigid implant materials is irrelevant clinically. That only has validity if the material is free floating and unattached or on a benchtop. But when the backing of the material is bone onto which it is placed this equalizes all material biomechanical features.

Stress shielding is an irrelevant issue on the face in which the bones carry limited stress loads. The face is not like the axial skeleton and is not an orthopedic bone site.

Dr. Barry Eppley

World Renowned Plastic Surgeon