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Medpor or porous polyethylene is one of the most common facial implant materials used. It is distinguished by having a significant or fierce soft tissue adherence to it. While this poses some challenges to revising or removing such implants, this should not be confused with impossible. A difficult task should not be mistaken for not able to be easily done. In reality the ‘difficulty’ in Medpor facial implants removal is a comparative one because non-adherent silicone implants are so easy to remove.

Having removed many Medpor facial implants I have had the opportunity to evaluate the tissue responses to them…and compare them to other facial implant materials.

In this case a female was having other surgeries (custom forehead implant) and it was discovered that she had residual remaining Medpor cheek implants from her 3D CT scan. The right cheek implant was supposedly previously removed but a residual segment of it remained. Her left cheek implant remained intact. She desired both of the cheek implants to be completely removed.

From an intraoral approach the left Medpor cheek was exposed which was just under the mucosa. In lift off the implant from the bone a thick fibrous capsule was seen between the implant and the underlying bone. On the bone the implant of the implant was seen.

The Medpor material develops a robust soft tissue response to it with a thick capsule both on the outer and inner surfaces. I have never seen bone ingrowth into it nor would I expect it to occur. It develops a circumferential capsule formation like very other implant material. It similarly creates an imprint or impression of the  implant outline on the bone like every other implant material. This is an expected amount of limited bone resorption caused by the placement of a material into a tissue site for which it was not genetically intended to carry. It is the body’s way of relieving the unnatural pressure on the tissues of the implant’s presence.

Dr. Barry Eppley

Indianapolis, Indiana

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