Which Is The Best Long Term Material For Custom Cheek Implants That Would Avoid The Need For A Revisional Surgery?

Q: Dr. Eppley, So I would like to place custom medpor cheek implants because I have read that over time it will adhere to the bone but I have also read that the risk of infection is higher than with silicone implants but I also read that silicone implants can cause bone erosion over time and that they were more likely to move, so I would like to know according to you which material is best for long term cheek augmentation without surgery revision and without the implant moving (for example for 60 years).

A: In answer to your custom cheek implant questions:

1) Every implant material has their own advantages and disadvantages, there is no one best material.

2) While Medpor does allow tissue ingrowth, it is considerably more expensive than silicone, does have a higher infection rate and is more difficult to revise/modify/remove.

3) Solid silicone remains the primary material I use for any custom facial implant as it is more economical, has  a lower infection risk and is much easer to revise/modify/remove should that be necessary.

4) It is a myth that silicone facial implants can move or migrate after they are healed in place. It is true that if you don’t screw them into place during surgery the size of the pocket needed to place any implant can allow them move then due to one slippery surface on another. (but not once healed) Thus the value of immediate screw fixation.

5) It is not realistic to believe that any implant placed in the face or body will never have a risk of revision. The most common reason for revision are aesthetic in nature not due to infection or ‘migration’. There is no guarantee that someone will like the aesthetic result or may feel the need to make some change in their size or shape, whether that is 60 days or 60 years after their placement.

Dr. Barry Eppley

Indianapolis, Indiana