Cheek Implant Removal - Why it is not possible to remove infected implants, clean them, put back into cheeks at the same time?
Doctor Answers (6)
Infection with cheek implants and reusing them
The infection is not only on the implant but in the tissue as well. It is the presence of the implant as a foreign body which prevents the infection in the tissue from clearing. If you replace the implant into a pocket of infected tissue you run the risk of just continuing the process. It is safer to remove it, clear the infection and then replace it in a sterilized non infected bed.
Remove And Immediate Replacement Of Infected Cheek Implants
While the most assured method of resolving any implant infection is to remove it and allow to settle down before replacement, it is not unreasonable to do an immediate re-insertion. This can be done with either a new or re-sterilized cheek implant after pocket irrigation...as long as the patient understands the risk of recurrent infection is higher than with the traditional approach. It is understandable that patients do not want to lose the effect of the implants or go around with an asymmetric face for a period of time. it is all about balancing the risks of doing so. Having done it more than once, immediate cheek implant replacement can be successfully done in some cases.
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Cheek Implant Infection Correction
When a cheek implant gets infected, the infection is in the tissue and on the implant (a biofilm). So, removing the implant and cleaning it, does not remove the infection in the tissue, even if the implant were sterilized. The tissues have to be cleared of infection. This requires using antibiotics and local wound care without an implant being present. Clearing an infection with an implant present is nearly impossible because implants create "hiding places" for bacteria where antibiotics and your body's infection fighting cells can't get.
So, after the implant has been removed, the infection has resolved, and several months have passed for resolution of inflammation and fibrotic tissue, the implant can be put back in. Certain types of implants can be reprocessed and put back. Silastic, for example, can be re-sterilized. Gortex for example can not. Most of the time, however, you just put a new implant in since the implant itself isn't the main cost.
Infected implants: why can't you clean them and put them back in?
Once a foreign body such as an implant gets infected it must be removed. Unfortunately, even if we wash it and cleanse with antibiotics there are still little "colonies" called biofilms that have grown on the device that can't be removed. The safest thing to do in these situations is remove the implant and allow a period of recovery. After three months, consideration can be given to replace the implant or perhaps use a material such as fat to augment the area.
Washing and Reusing Infected Cheek Implants
You are obviously a loyal follower of the "4 second rule" - a dropped piece of food that is picked off the floor in under 4 seconds is safe to eat...
Seriously, now. Once a cheek implant is colonized / infected, it is covered with a layer of biological crud called a biofilm. This layer is not always washable and the biofilm and bacteria in the pocket are never 100% removed even with vigorous irrigation. Since the surgery is done through the human mouth, second only to some Madagascar lemurs and the Komodo dragon for potentially harmful bacteria, you are operating through a contaminated environment.
The best way is to remove the implants, allow the areas to heal completely and come back in a few months when the risk of recontamination is much lower.
Dr. Peter A Aldea
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.