Facial Implants: Controversies and Criticism. A Comprehensive Review of the Current Literature

BACKGROUND:Polyethylene (Medpor) and silicone are two of the most popular materials used today for facial skeleton implantation. Previous studies have identified common complications with the use of these implants, but patient follow-up has been short. This review of the literature examines complica...

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Veröffentlicht in:Plastic and reconstructive surgery (1963) 2018-10, Vol.142 (4), p.991-999
Hauptverfasser: Rojas, Yoel A., Sinnott, Catherine, Colasante, Cesar, Samas, John, Reish, Richard G.
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container_end_page 999
container_issue 4
container_start_page 991
container_title Plastic and reconstructive surgery (1963)
container_volume 142
creator Rojas, Yoel A.
Sinnott, Catherine
Colasante, Cesar
Samas, John
Reish, Richard G.
description BACKGROUND:Polyethylene (Medpor) and silicone are two of the most popular materials used today for facial skeleton implantation. Previous studies have identified common complications with the use of these implants, but patient follow-up has been short. This review of the literature examines complications and patient follow-up in cases using Medpor and silicone implants for reconstructive and aesthetic operations of the mid and lower face over the past 20 years. METHODS:A literature search was conducted through the PubMed database. Keywords used were as follows(“mandible implants” or “malar implants” or “chin implants”) AND (“reconstruction” or “augmentation”) AND (“Medpor” or “silicone”). RESULTS:There were nine studies with 626 patients in the Medpor group and five studies with 365 patients in the silicone group. The silicone group had a higher incidence of infections and displacements. The Medpor group showed a higher incidence of prominence problems. Exposure/extrusion rates were low for both implant types. Chin and mandibular implants were the safest, whereas malar implants had a high incidence of prominence problems. The average follow-up for Medpor was 36.6 months and 24 months for silicone. There were wide ranges of follow-up times, from 2 weeks up to 15 years. A limited number of articles included an averaged time within their ranges. Reported follow-up times were not linked to specific complications. CONCLUSIONS:Medpor implantation is more common than silicone. Complication rates are low with the use of both materials. Patient follow-up is deficient and has not improved in the past 20 years, raising questions on the reliability of complication rates.
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A Comprehensive Review of the Current Literature</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Rojas, Yoel A. ; Sinnott, Catherine ; Colasante, Cesar ; Samas, John ; Reish, Richard G.</creator><creatorcontrib>Rojas, Yoel A. ; Sinnott, Catherine ; Colasante, Cesar ; Samas, John ; Reish, Richard G.</creatorcontrib><description>BACKGROUND:Polyethylene (Medpor) and silicone are two of the most popular materials used today for facial skeleton implantation. Previous studies have identified common complications with the use of these implants, but patient follow-up has been short. This review of the literature examines complications and patient follow-up in cases using Medpor and silicone implants for reconstructive and aesthetic operations of the mid and lower face over the past 20 years. METHODS:A literature search was conducted through the PubMed database. Keywords used were as follows(“mandible implants” or “malar implants” or “chin implants”) AND (“reconstruction” or “augmentation”) AND (“Medpor” or “silicone”). RESULTS:There were nine studies with 626 patients in the Medpor group and five studies with 365 patients in the silicone group. The silicone group had a higher incidence of infections and displacements. The Medpor group showed a higher incidence of prominence problems. Exposure/extrusion rates were low for both implant types. Chin and mandibular implants were the safest, whereas malar implants had a high incidence of prominence problems. The average follow-up for Medpor was 36.6 months and 24 months for silicone. There were wide ranges of follow-up times, from 2 weeks up to 15 years. A limited number of articles included an averaged time within their ranges. Reported follow-up times were not linked to specific complications. CONCLUSIONS:Medpor implantation is more common than silicone. Complication rates are low with the use of both materials. Patient follow-up is deficient and has not improved in the past 20 years, raising questions on the reliability of complication rates.</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/PRS.0000000000004765</identifier><identifier>PMID: 29994843</identifier><language>eng</language><publisher>United States: by the American Society of Plastic Surgeons</publisher><subject>Adult ; Biocompatible Materials - therapeutic use ; Chin - surgery ; Face - surgery ; Genioplasty - adverse effects ; Genioplasty - methods ; Humans ; Mandible - surgery ; Polyethylenes - therapeutic use ; Postoperative Complications - etiology ; Prostheses and Implants ; Prosthesis Implantation - methods ; Reoperation - statistics &amp; numerical data ; Risk Factors ; Silicones - therapeutic use ; Treatment Outcome</subject><ispartof>Plastic and reconstructive surgery (1963), 2018-10, Vol.142 (4), p.991-999</ispartof><rights>by the American Society of Plastic Surgeons</rights><rights>2018American Society of Plastic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4675-3d5b02471c1bd731861fe351a1874bfa9b92cd316ad16e618112d70736bcd9553</citedby><cites>FETCH-LOGICAL-c4675-3d5b02471c1bd731861fe351a1874bfa9b92cd316ad16e618112d70736bcd9553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29994843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rojas, Yoel A.</creatorcontrib><creatorcontrib>Sinnott, Catherine</creatorcontrib><creatorcontrib>Colasante, Cesar</creatorcontrib><creatorcontrib>Samas, John</creatorcontrib><creatorcontrib>Reish, Richard G.</creatorcontrib><title>Facial Implants: Controversies and Criticism. A Comprehensive Review of the Current Literature</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>BACKGROUND:Polyethylene (Medpor) and silicone are two of the most popular materials used today for facial skeleton implantation. Previous studies have identified common complications with the use of these implants, but patient follow-up has been short. This review of the literature examines complications and patient follow-up in cases using Medpor and silicone implants for reconstructive and aesthetic operations of the mid and lower face over the past 20 years. METHODS:A literature search was conducted through the PubMed database. Keywords used were as follows(“mandible implants” or “malar implants” or “chin implants”) AND (“reconstruction” or “augmentation”) AND (“Medpor” or “silicone”). RESULTS:There were nine studies with 626 patients in the Medpor group and five studies with 365 patients in the silicone group. The silicone group had a higher incidence of infections and displacements. The Medpor group showed a higher incidence of prominence problems. Exposure/extrusion rates were low for both implant types. Chin and mandibular implants were the safest, whereas malar implants had a high incidence of prominence problems. The average follow-up for Medpor was 36.6 months and 24 months for silicone. There were wide ranges of follow-up times, from 2 weeks up to 15 years. A limited number of articles included an averaged time within their ranges. Reported follow-up times were not linked to specific complications. CONCLUSIONS:Medpor implantation is more common than silicone. Complication rates are low with the use of both materials. 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A Comprehensive Review of the Current Literature</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>2018-10</date><risdate>2018</risdate><volume>142</volume><issue>4</issue><spage>991</spage><epage>999</epage><pages>991-999</pages><issn>0032-1052</issn><eissn>1529-4242</eissn><abstract>BACKGROUND:Polyethylene (Medpor) and silicone are two of the most popular materials used today for facial skeleton implantation. Previous studies have identified common complications with the use of these implants, but patient follow-up has been short. This review of the literature examines complications and patient follow-up in cases using Medpor and silicone implants for reconstructive and aesthetic operations of the mid and lower face over the past 20 years. METHODS:A literature search was conducted through the PubMed database. 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subjects Adult
Biocompatible Materials - therapeutic use
Chin - surgery
Face - surgery
Genioplasty - adverse effects
Genioplasty - methods
Humans
Mandible - surgery
Polyethylenes - therapeutic use
Postoperative Complications - etiology
Prostheses and Implants
Prosthesis Implantation - methods
Reoperation - statistics & numerical data
Risk Factors
Silicones - therapeutic use
Treatment Outcome
title Facial Implants: Controversies and Criticism. A Comprehensive Review of the Current Literature
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