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

  • Jeremie D. OliverEmail author
  • Annica C. Eells
  • Elias S. Saba
  • Daniel Boczar
  • David J. Restrepo
  • Maria T. Huayllani
  • Andrea Sisti
  • Michael S. Hu
  • Daniel J. Gould
  • Antonio Jorge Forte
Systemic Review Facial Surgery
  • 30 Downloads

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

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Face Alloplast Implant Aesthetic Reconstructive Augmentation Outcomes Review 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, informed consent is not required.

Supplementary material

266_2019_1370_MOESM1_ESM.docx (29 kb)
Supplementary material 1 (DOCX 28 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  • Jeremie D. Oliver
    • 1
    Email author
  • Annica C. Eells
    • 2
  • Elias S. Saba
    • 1
  • Daniel Boczar
    • 5
  • David J. Restrepo
    • 5
  • Maria T. Huayllani
    • 5
  • Andrea Sisti
    • 5
  • Michael S. Hu
    • 3
  • Daniel J. Gould
    • 4
  • Antonio Jorge Forte
    • 5
  1. 1.Mayo Clinic School of MedicineMayo ClinicRochesterUSA
  2. 2.Mayo Clinic School of MedicineMayo ClinicScottsdaleUSA
  3. 3.Department of Plastic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  4. 4.Division of Plastic and Reconstructive SurgeryUniversity of Southern California Keck School of MedicineLos AngelesUSA
  5. 5.Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo ClinicJacksonvilleUSA

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