Facial Implants, Part I
Introduction
People who choose to have facial implants detect a disproportion in the shape of their
faces. Sometimes the defect is caused by the underlying shape of the bones and other times
it is caused by the defect in soft tissues overlying the bone.
Implants that are used to improve the contour of the face must be non-toxic, well
accepted by the body, look and feel natural, and not go away with time.
The surgeon usually chooses to use hard implants to reconstruct bone and soft or liquid
implants for soft tissues.
Facial implant surgery can be done as an outpatient procedure under local or general
anesthesia.
Complications such as infection and bleeding are rare but may occur as is true for all
surgery. A unique complication of foreign materials used, such as solid silicon, is the
possibility that they may not be positioned correctly. Should there be infection, the
solid implants would have to be removed for a time and then replaced later.
Below are some of the procedures that are available.
Nose
The two natural implants available for improving the bony contour are bone and
cartilage. The artificial materials available are hydroxyapatite (combination of calcium
with phosphate), solid silicone, Gortex and polyethylene among the many choices.
The materials used for minor soft tissue defects are the person's own fat or skin
(dermis) or artificial liquid products such as collagen or other newer products not yet
available in the U.S.
The disadvantage of natural materials is that they may get smaller because of
absorption.
The reason for using artificial materials is the ease of obtaining them and the
unlimited supply. The disadvantage of artificial materials is the risk of infection
requiring their removal.
People who choose to have nasal implants are usually those who are born with flat noses
or those who have had too much bone removed from their noses during previous surgeries.
The first patient below is an example of a person who had a silicone implant placed in
her nose. The procedure is done with mild IV sedation and local anesthesia of the nose and
upper lip. The implant was placed through a small incision under the upper lip and tunneled
upwards through the wall between the nostrils and then onward over the bony spine of the
nose. The type of implant used is pictured.
The second patient had an irregular spine of her nose from previous surgery. Cartilage
from her ear was used for a graft on the spine of the nose. Several small pieces were
stacked together and placed in a pocket in the tip of her nose.
(This article will be continued in
Facial Implants, Part II,
which will explain about cheek, lip and chin implants, as well as fat injections for
the face).
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