Securing Facial Implants to the Bone - An Easy Way to Avoid Complications

By Dr Barry Eppley

The most common complication of facial implant surgery is that the implant shifts or moves out of position after surgery. From an outward appearance, this can create an asymmetry between two facial sides or, at the very least, some undesired changes in the external facial appearance. In the worst case scenario, the implant can potentially move toward the incision that it was put in through and, over time, actually extrude and become exposed. Although rare, I have seen it happen and when it does occur, it is from an incision in the mouth rather than an external skin approach.

The way to avoid these facial implant problems is a simple one. Rigidly secure the implant to the bone so that it can never move. This is done by using a single screw or two which is placed through the implant down into the bone. This extra step will eliminate implant shifting forever. It takes but a few extra minutes and is well worth it in my opinion. This is my preferred technique for all facial implants.

Many patients may have some concerns about metal screws in their face. Such as will they interfere with x-rays? Will I be able to feel them? Will the scanner at the airport go off? The answer to all of these concerns is no. The screws used are very small (only 1.5mm to 2.0mms in size) and are made of titanium, a metal alloy that does not corrode and is non-ferromagnetic. (will not interfere with x-rays) In addition, the screw is placed into the implant so that it is flush with the outer surface of the implant, making it impossible to feel even if you were rubbing right across the actual implant itself. When you put the thickness of your facial tissues on top of the implant, you now know why it is impossible to feel it.

The use of small metal screws to secure facial implants permanently into place provides great security for the plastic surgeon and the patient alike. It adds no risk to the procedure and a very minimal cost. (usually about 10% of the cost of the actual implant itself, around $35 - $50) If your plastic surgeon does not suggest it, I would ask about it.

Dr Barry Eppley is a board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. (http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com