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Alloplastic Facial Implants: A Systematic Review and Meta-Analysis on Outcomes and Uses in Aesthetic and Reconstructive Plastic Surgery

  • Systemic Review
  • Facial Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Alloplastic materials in facial surgery have been used successfully for various applications in the reconstructive restoration or aesthetic augmentation of the facial skeleton. The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized to augment the facial skeleton stratified by anatomical distribution, indication, specific material used, and respective outcomes.

Methods

A comprehensive systematic review on alloplastic facial implant data was conducted utilizing Medline/PubMed database. Articles were stratified by (1) anatomic localization in the face, as well as (2) alloplastic material.

Results

A total of 17 studies (n = 2100 patients, follow-up range = 1 month–27 years) were included. Overall, mersilene mesh implants were associated with the highest risk of infection (3.38%). Methyl methacrylate implants were associated with the highest rate of hematoma (5.98%). Implants placed in the malar region (2.67%) and frontal bones (2.50%) were associated with the highest rates of infection. Implants placed in the periorbital region were associated with the highest rate of inflammation (8.0%), explantation (8.0%), and poor cosmetic outcome (17.0%). Porous implants were shown to be more likely to potentiate infection than non-porous implant types.

Conclusions

Alloplastic facial implants are a reliable means of restoring facial symmetry and achieving facial skeletal augmentation with a relatively low complication profile. It is important for plastic surgeons to understand the relative risks for each type of implant to develop postoperative complications or poor long-term cosmetic results. Interestingly, porous implants were shown to be more likely to potentiate infection than non-porous implant types.

Level of Evidence III

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Author information

Authors and Affiliations

  1. Mayo Clinic School of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA

    Jeremie D. Oliver & Elias S. Saba

  2. Mayo Clinic School of Medicine, Mayo Clinic, Scottsdale, AZ, USA

    Annica C. Eells

  3. Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Michael S. Hu

  4. Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Daniel J. Gould

  5. Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA

    Daniel Boczar, David J. Restrepo, Maria T. Huayllani, Andrea Sisti & Antonio Jorge Forte

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  1. Jeremie D. Oliver
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Correspondence to Jeremie D. Oliver.

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This study was supported in part by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

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Oliver, J.D., Eells, A.C., Saba, E.S. et al. Alloplastic Facial Implants: A Systematic Review and Meta-Analysis on Outcomes and Uses in Aesthetic and Reconstructive Plastic Surgery. Aesth Plast Surg 43, 625–636 (2019). https://doi.org/10.1007/s00266-019-01370-0

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