Q: Dr. Eppley, As for the cheek implants, I was running on my deck last month and slipped- hit my brow (split it open, now a scar) cheek bone and some rib cracks- landed on the brick, hit so hard and fast it knocked me out for almost a minute! just starting to heal from that, what concerned me was if it had the cheek implants, what would have happened to the screw in there- it would have been jammed into my bone or broken off.
A: Your question is a good and not uncommon one…what would happen to my facial implants in the event of trauma? Despite having placed thousands of facial implants over 30 years, and certainly some of those patients have had facial trauma, the actual clinical situation or complications has never occurred to my knowledge.
I would hypothesize that nothing adverse would happen because the implant is ‘locked’ into place by the surrounding scar tissue. (capsule) The screw at that point is not what is holding it into place. The purpose of the screw is to merely hold it into the desired position long enough so that the scar tissue grows around it and secures it into place. The scar tissue or capsule has a shrink wrap effect on the implant. The scar has not purpose at that point and is a passive device at that point. These are screws are very small son they are neither going to break off or become displaced into the bone.
Conversely, I have always argued that implants have a protective effect on the bone because they are softer than it is. Like a piece of firm rubber you can’t break them, like bone or glass, and they merely allow the force to be displaced (deflected) outward…protecting the underlying bone much like a bumper guard.
Dr. Barry Eppley