Facial Implants Performed by Paul Wilson in Bristol

There are several materials commonly used in facial implants. They include Medpore, PEEK, titanium, polymethylmethacrylate, hydroxyapatite bone cements and silicone. Each of these materials has its own advantages and disadvantages. The best material to use depends on the specific problem.

Silicone
My preferred material for preformed implants is Silicone. Silicone implants are useful in the cheeks, chin and at the mandibular angles. They are easy to insert via small incisions and can be fixed to the facial bones with titanium screws to prevent displacement and migration.

The brand of silicone implants we use is Implantech

Medpore
Medpore is a biocompatible, porous polyethylene implant that can be readily shaved and adjusted during surgery. It is generally securely fixed to the facial bones with small retaining screws and so there is no risk implant movement after insertion. It is particularly good material for augmenting cheeks and the forehead. I occasionally also use it as a small chin implant.

Titanium
Titanium is a very good material for skull reconstruction or cranioplasty that has limited use in the face.

PEEK
PEEK (Polyether ether ketone) is a biocompatible plastic which is most commonly used in the construction of custom-made implants. The fact that the material can be shaped exactly into complex shapes makes it very effective in both reconstruction and aesthetic surgery

Surgery can be performed either under general anaesthetic or local anaesthetic with sedation. Most people can go home on the day of surgery although occasionally an overnight stay is required.

A small incision is made close to where the implant is to be placed and the implant is attached to the bone. Usually the implant is secured with several small titanium screws so that there is no chance of movement of the implant after the operation. Implants to the cheeks and lower jaw are often placed through incisions in the mouth. Incisions beneath the chin, at the angle of the jaw and in the lower eyelid are also occasionally used. Forehead and skull implants are usually placed through incisions within the hairline.

Antibiotics are usually given at the time of surgery and for 3 to 4 days afterwards to reduce the risk of infection. There is usually small amount of post-operative swelling, which persists for 1 to 2 weeks.

The placement of facial implants is usually very straightforward operation. There’s a small risk of infection and if this occurs the implant may have to be removed and replaced later after the infection has subsided.

There is a small risk of implant malposition, migration or extrusion.

Implants are often placed close to major sensory nerves in the face, around the lower jaw and cheeks. Sensory disturbance maybe transient and is rarely permanent.

Fat grafting with your own fat (autologous fat) can be used to augment your cheeks and temporal hollows. Fat is harvested from your trunk or thighs and is prepared for implantation.

To increase the chances of the fat graft ‘taking’ the fat can be filtered, centrifuged, extracted and mixed with harvested fat using a device called the Lipocube.

Implants can be placed at the same time as facelift surgery, eyelid surgery, forehead reduction or rhinoplasty.

Chin implants are often placed at the same time as rhinoplasty to reduce the size of the nose and increase the size of a small or receded chin.