Cheek Implants Infected - Should They be Removed?

Although the insertion of cheek implants
is usually straightforward it can relatively rarely by complicated with
infection. There is a natural flora of microbes that live in your mouth, and
the nature of inserting cheek implants through the mouth and thereby hiding
incisions means there is a small risk of infection with every cheek implant. An
infected cheek implant will typically result in symptoms including fever,
swelling, discomfort and pain. With an early infection, antibiotics can be
effective in curing the infection without further treatment and without removal
of the implant. Some surgeons have described washing of the implant with
antibiotics in conjunction with oral antibiotics as an effective method of
treating an early infection. However in the relatively uncommon situation of an
apparent cheek implant which has become infected, if the implant is not
improving with antibiotics, the treatment will require removal of the implant, allowing
a period of time for the infection to resolve, followed by re-insertion of a
new implant 3-months later. Dr. De Silva utilises silicone cheek implants which
are relatively straight forward to insert and remove, however other types of
implant (including Medpor) can be challenging to remove as the body can heal
with the implant making it difficult to remove.

A course of antibiotics and conservative therapy is always the first approach to an infected implant.  Depending on the amount of infection, it potentially can clear with just the antibiotics.  Because implants are avascular, there could be persistent seeding of bacterial cells despite initial successful control of on infection with antibiotics.  If the infection is recurrent or recalcitrant, then removal of the implant is necessary.

Antibiotics and drainage with a rubber drain may lead to healing without removal of the implant. I would try that first.

Any artificial substance that gets infected needs to be removed unless the infection can be contained early. Removal of cheek implant is not as easy as placing them in . The determining factor is the type (silicone vs medpor) Also the implants tend to erode into the cheekbones and cause asymmetry. There will be sagging but some of that may contract due to your age and hopefully good skin quality.

Not all infected cheek implants are lost.   Antibiotics, drainage and irrigation can save some of them.   Hang in there and hopefully you will be one of the lucky ones.

Good Luck!   Dr Grant Stevens      

In general an infected implant will likely end up needing to be removed.  However, it's reasonable for you to get antibiotics to try to eradicate the infection.  I would keep in close contact with your plastic surgeon and visit him/her regularly.  I'm sure he/she is diligently monitoring your implant and your infection.  If you have any questions, I'm sure he/she would be happy to take the time to answer them.

Dr. Cat Begovic M.D.

First you must be sure they are infected. Swelling, pain and  reddness, fever, purulent discharge from the incision site are all signs of infection and the implant must be removed. Can be replaced approximately 3-6 months later.

For a text book answer it would be favoring removal. I also recommend removal, but you might be oner of the few who when treated with antibiotics can retain the cheek implants. Discuss with your surgeon. 

If you had cheek implants placed and developed swelling and fever, this may well have been an infection and antibiotics should be the first course of action.  If the swelling is going down and the fever has subsided, I would suggest you complete your antibiotic course.  You may not have to remove the implants.  If the fever and swelling return then removal probably would be the best option.

Removal may be necessary, but drainage with antibiotic therapy may solve your problem. If this is successful, it certainly will be easier than removal followed by another operation to replace the implants. I agree with your surgeon's approach to treat this complication.