Any person not related to the world of plastic surgery would be quite amazed to learn what a diversity of implants (silicone protheses) are emplaced in patients’ faces and bodies on daily basis all over the world. Today implants are used to solve a whole range of problems.

First of all – breast augmentation – the procedure when a circular shaped endoprothesis (can be filled with silicone gel or saline solution) is emplaced inside of the breast, under lacteal gland or under a muscle.

Huge number of face implant emplacements are also performed. In this case full body implants are used. This type of implants is not filled with anything. They are just homogeneous pieces either of silicone rubber or of porous polyurethane resin that grow into tissues during several months after the operation.

This kind of prosthesis is instrumental to change shape or size of a chin or to enhance cheek bones, it also helps to reshape shins and buttocks. Implants are used in rhinoplasty to complement surgical procedures: as it’s often hard to get best results by simple reduction of nasal tissues.

Photo: the result of rhinoplasty and chin implant enhancement

So how does the foreign body behave inside human organism? The answer is that there is no exact answer. Breast implants here are the most predictable and major problems arise from improper placement of prosthesis, its displacement and, as a result, unattractive and sometimes asymmetrical breast shape. Some other problems can include formation of fibrous capsule when an implant accretes with extra firm connective tissue which compresses and compacts it. There are usually no inflammations after breast augmentation surgery as opposed to chin/cheek bone implants that often are accompanied by inflammatory reaction.

There is a substantial risk of infection when chin or cheek prostheses are concerned. In case of cheek implants, inflammation can only affect one side of the patient’s face that adds a problem of asymmetrical embedding of implants.

Nose implants like the ones in nasal septum are almost alway fraught with problems. These prostheses are very likely to bring inflammation, suppuration and further removal of an implant. It’s actually a much more successful scenario with transplants: patient’s own cartilages taken from his/her own nose (deeper chambers of nasal septum) or from his/her ears.

What does implant survival depend on? The main factor is the level of sterility that is maintained in the treated area. There is a major concentration of bacteria in the nose so it’s almost impossible to sterilize this area for successful implant emplacement. The problem is that silicone as well as other artificial materials attracts infection. That same bacteria can be found on transplants as well but there it’s fought by white blood cells that neutralize it. The weakness of artificial material is that white blood cells are helpless with it. Hence, the closer the operated area is to bacteria epicenter, the greater is a chance of inflammation.

Breast areas are located far enough from points of natural disposal (mouth, nose, denials) and, therefore are easier to sterilize. When implant is emplaced through the mouth (as is the case with chin/cheek implants) presence of microbes is inevitable.

This principle works in any area of the body. We can see a huge difference in implant survival in inner and outer thigh. Inner thigh is located close to genitals and consequently to microbes.

Posted under: Face surgery