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I'm very interested in facial implants. I have a few questions: 1) Can they be felt...

Q:

I'm very interested in facial implants. I have a few questions:

1) Can they be felt and seen through the skin after?

2) What is the best material for them, Gore-Tex or silicone?

3) Can I wear them for my whole life or I will I need to swap them in 10-15 years?

4) Is there any chance my cheeks will be asymmetrical?

A:

These are the answers to your facial implant questions:

1. Facial implants should not be readily palpable or visible.

2 .There are many materials utilized for implants of the face, with Gore-Tex and silicone being the most common.

3. Unless the implants become complicated or problematic in some way, they can stay in place for life.

4. There is always some facial asymmetry before and after surgery, but it is usually not very noticeable. Sometimes corrective surgery is required if the asymmetry becomes too great.

A:

 

A wide variety of facial implants are currently available for the enhancement of the skeletal elements of facial aesthetics. The most commonly used facial implants are used to enhance the profile of the chin and the cheeks. Facial implants very widely not only in shape and style, but also in terms of the materials from which they are fabricated.

My preference is to use structural fat grafting, as much as possible, to enhance facial features. In many cases, the need for a solid implant can be eliminated by the careful and meticulous grafting of a patient's own fat. While the incidence of complications with facial implants is not high, certain problems may develop which require implant removal including infection and implant migration. Bone resorption (bone loss) has also been reported below solid facial implants. Neither of these problems are an issue with structural fat grafting.

There is yet another reason patients prefer the results of fat grafting, many plastic surgeons who perform structural fat grafting report that patients often describe a variety of improvements in their facial skin following fat grafting surgery. This observation has led to the use of fat grafting in reconstructive surgery, for instance in the management of chronic wounds such as those seen in some patients following radiation treatment for cancer. Fat grafting into the tissues below a chronic, non-healing wound has been shown to stimulate successful wound healing in a number of studies.

So what is responsible for this effect? Many of us suspect that it is produced by 'stem cells' which are known to be present in abundance in human adipose (fatty) tissue. Stem cells are very dynamic human cells which have the capacity to be transformed into any number of cell types (fat, muscle, skin, fascia, etc), and which are capable of producing a variety of proteins which promote the repair of damaged cells and tissues.

Much of the evidence has been anecdotal, i.e. the personal observations of physicians made while treating patients in their usual clinical practice, outside the setting of a specific scientific study. A great deal of basic science research is now being done to specifically determine cause and effect, and it is certain that over the next few years we will gain a much clearer understanding of the healing properties of fatty tissue and stem cells.

 

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