An Easy and Effective Technique for Silicone Facial Implant Insertion and Fixation to Periosteum

Abstract

In this paper, we present a simple way to place the implant into a harvested pocket and to subsequently fix it percutaneously. Eighteen patients (1 male, 13 females, 4 transgender), underwent facial implant placement; a total of 31 implants were placed (1 pair of angles of the mandible implants, 12 pairs of malar/sub-malar implants, and 5 chin implants). The intraoral approach was performed on 15 patients, and on the remaining three patients, the sub-ciliary lower lid approach was preferred. Patients were followed up for at least one year with a maximum follow-up of seven years (mean 1.8 years). In all the cases, except one, patients healed without complications. One case of implant displacement and infection was recorded. No other complication was documented. The technique described is similar to the one suggested by Peled, although some useful tips were added, namely the use of sutures, not only to fix the implant but also to drive it into the harvested pocket. In addition, larger absorbable “left in place” sutures were used, avoiding accidental implant dislocation during their removal. Further studies are required to gain a more complete understanding of the effectiveness and reproducibility of this surgical technique.

Polymeric materials and processes to produce facial reconstruction implants: A review

“…Major challenges with the use of silicone rubber implants includes difficulty of fixating the implant to the implantation site [2,30]. This has led to concern over the use of silicone rubber implants which may include possible implant slipping and extrusions.…”

“…This has led to concern over the use of silicone rubber implants which may include possible implant slipping and extrusions. As a result of silicone rubber having low permeability rates, the use of this material for implants lacks the ability to allow cell proliferation, and tissue ingrowth to assist with implant fixation [30,31]. Medical-grade silicone rubber material for use as medical implants is available as prefabricated standard shapes which may need further carving and modifications for an acceptable patient fit [30,32].…”