Thank you for your question. You state you had cheek implants removed after 1 month due to infection in both of them. You state it’s rare for this to occur, so you’re concerned about whether or not you have some underlying issue with your body’s defense, and you’re looking for some explanation. You also say you’re falling into depression about this event. In the absence of knowing your full medical history and other important details, I can give you some general ideas about what I would consider when something like this happens. You should also understand the risks when you place any type of foreign of substance in your body. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Facial implants, and body implants are a big part my surgical practice, including cheek implants, chin implants, and breast implants. There are many important variables likely related to your situation. The simplest is the reality with cheek implants is we’re actually going through the mouth as a standard procedure, which even with extensive cleaning prior to the surgery and placing patients on antibiotics before surgery, we refer to the mouth as a dirty area. This is an area that naturally has a lot of bacteria. When the implant is placed, and once it is fixated, we irrigate that area with antibacterial solution, and place the stitches in a way to allow for any type of drainage so anything going on in the inside can drain out. There is a potential risk as an implant doesn't have a blood supply. It’s common for bacteremia where bacteria is in your blood such as when you brush your teeth, can potentially seed the implant and cause this type of infection. This can happen to a cheek implant, chin implant, a breast implant, even in injectable fillers. You can place an injectable filler, and nothing happens, until suddenly, somebody can develop an infection. With injectable fillers, we also think about the bacteria on the skin, so even with good cleaning, infection can happen with something called biofilm. Whatever we do with medicine, when we’re crossing a natural barrier, there is the risk of infection whether it’s from the time of the surgery, or routine daily life. In addition, there’s a greater colonization of people’s respiratory tracts and bodies with relatively resistant bacteria. This particularly applies to people who work in healthcare who work in hospitals and other areas where there’s a lot of use of antibiotics that can isolate a lot of resistant bacteria. It’s become part of my routine to discuss with patients who work in hospitals about the relative risk of infections, whether it’s MRSA or any other type of infection that can be due to that environment, and be colonized. We live in a very interesting time where antibiotics, whether used liberally in the medical field, food products, and the things we take in has changed a lot, and created a lot of risks relative to infections. Even when you’re not doing implants, you can still get infections with any surgery. It’s appropriate for you to discuss this with your medical doctor. Have your medical doctor do routine lab tests and make sure you are otherwise healthy. You don't want to just give up as there is still an opportunity for you to consider enhancing the cheeks not necessarily with implants, but maybe with injectable fillers. The reason I’m saying is injectable fillers such as those in the hyaluronic acid filler family such as Juvederm Ultra Plus, and Juvederm Voluma are long lasting fillers that has become a major part of my own practice as an alternative to implants. I find myself gravitating towards doing these because of the control, and the ease and convenience for our patients. With the concern of potential infection, it’s important you bring that information to the prospective doctor. We do this procedure called Structural Volumizing in a way like we do surgery. We do everything in a sterile technique, we clean in a way as if we were doing a surgical procedure, even though it’s done in an exam room and place the filler using special instruments. We place filler at the bone level so you can get this nice, natural-looking enhancement without looking overly done, comparable to a cheek implant. The other thing really nice about this method is if you were to have an infection, it’s not a surgical solution as we can dissolve the filler with an enzyme called hyaluronidase. Once the foreign body as I discussed earlier is gone ,which is the filler, then the bacteria has nothing to live on top of. I think you should allow yourself a chance to heal after this procedure. Discuss this with the doctor who performed your surgery, and trust the option of having the cheek fillers as opposed to another surgery, but it’s a matter of discussion with you and your doctor. I hope that was helpful, I wish you the best of luck, and thank you for your question.