Cheek implants with screws?

Question

I had a consultation with a doctor yesterday and he does cheek implants (silicone I think) by screwing them into the bone. Is this common? If 10 years from now God forbid I get them infected, will screws be hard to take out? Does the implant start incorporating into the bone over time?

George Volpe, MD · Answer

Although probably most surgeons do not use screws for silicone cheek implants, the titanium screws used may help an implant stay in position if a pocket is a bit larger than expected when it is being created. If an implant were to become infected in the future, the screws can be used although the brand should be known as special screwdrivers are sometimes needed for certain screws. Usually the screws if properly placed and sized do not cause significant issues although care must be taken to avoid issues with the sinuses.

Michael I. Echavez, MD · Answer

Each surgeon will have an individual preference for how cheek implants are placed.  I personally do not use screw fixation of cheek implants but fix them externally for 3 days.  After this point, a capsule normally forms around the implant and will hold it in place.

Zoran Potparic, MD · Answer

Fixation of chin implant with a screw is an option which is not practiced by many plastic surgeons. However, some type of implants or a particular clinical situation may dictate the use of screw fixation. Removal of the screw used for fixation is simple procedure even if done years after implant placement. Good luck with your surgery.

William Portuese, MD · Answer

In our practice, we placed cheek implants without screw fixation. Cheek implants manufactured In a  parietal he of sizes and shapes( malar, and  sub-malar), and are composed of  Silastic. It's very rare to see an infection occur many years down the road after they are placed.

Barry N. Silberg, MD, FACS (retired) · Answer

I use a check implant that is covered with ePTFE.  That is the same material that is used to make vascular implants.  These implants don't form the type of capsule seen with pure silicone implants.  They cost a little more but don't tend to move around.  The surface is a little rough and this keeps them in place without using screws.

Stuart H. Bentkover, MD (retired) · Answer

I started using micro screws to hold cheek implants in place a number of years ago.  I think it holds them better  until a capsule forms around the implants. These are the same screws we use for plates in fractures.  Infection risk should be very, very low.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,All silicone implants whether breast, cheek, chin, jaw, nasal or any other implant, form a capsule around the implant over time. This is a result of your body's immune system encapsulating the implant. Silicone implants are never "rejected" by your body as say in organ transplantation, because silicone is an inert substance and the immune system can form an appropriate immune response as it does with viruses, bacteria or any other "foreign invader". Typically the screws used are small self-tapping self drilling 4-6 mm screws to secure the implant and prevent it from moving. However, as with any implant, there is slight risk of infection. This typically will become apparent within 3 to 4 weeks post-op. If that happens and the implant needs to be removed, the beauty of sililcone implants is that they easily slip right out of the pocket and removing the screw is not an issue. In contrast to say a medpor implant, which has tissue ingrowth and can be difficult if not impossible to remove without cutting out normal tissue or even bone. I have removed medpor implants and in many cases the medpor is so fixed to bone or tissue that it cannot be removed without damaging normal tissue.In my opinion, silicone implants with screw fixation is the best way to go.Best,Dr.S.

Cheek implants with screws?

Answers (7)

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