The most common complication of facial implant surgery (such as a cheek or chin implants) 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, less than the desired facial change thaty the patient wants. In some rare cases, a loose facial implant (usually a cheek implant) can actually extrude through the incision that it was put in through into the mouth.
The way to avoid this potential facial implant problem 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 when placing most 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? Will they eventually get lose?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. It is may be possible for a screw to eventually get loose but the scar around the implant at that point will hold it in its place.
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 does so at a very minimal cost.
Dr. Barry Eppley
Indianapolis, Indiana