Facial implants; controversies an d 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 literature examines complications and patient follow up in cases using Medpor and Silicone implants for reconstructive and aesthetic surgeries of the mid and lower face over the last 20 years. METHOD: A literature search was conducted through the PUBMED database. Key words used were ("Mandible Implants" or "Malar Implants" or "Chin Implants") AND ("Reconstruction" or "Augmentation") AND ("Medpor" or "Silicone"). RESULT: There were 9 studies with 626 patients in the Medpor group and 5 studies with 365 patients for Silicone. Silicone had a higher incidence of infections and displacements. Medpor showed a higher incidence of prominence problems. Exposure/extrusion rates were low for both implants. Chin and mandibular implants were the safest, while 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 ups were not linked to specific complications. CONCLUSION: Medpor implantation is more common than Silicone. Complications rates are low with the use of both materials. Patient follow up is deficient and hasn't improve in the last 20 years, raising questions on the reliability of complications rates. FD - None of the authors have financial disclosures. Corresponding author: Yoel Rojas, MD1, Department of Plastic Surgery, Nassau University Medical Center, East Meadow, NY 11554 ©2018American Society of Plastic Surgeons

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