Are silastic implants better than porex (Medpor) implants?

Thanks for your question.I do not recommend either for nasal procedures.For facial each one has advantages/ disadvantages. An in person consultation would be best to discuss specific given your facial anatomy.Best wishes

You will likely hear different answers from different surgeons on RealSelf. My personal preference is to use Silastic implants for all facial augmentation cases - cheek and chin. The largest issue with Medpor is that tissue ingrowth into the implant can make it very, very difficult to change the implant or reposition the implant if necessary. I don't think that Medpor offers any advantages for facial augmentation. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

What is important to remember about any facial implant is can it do the job effectively and how easily is it to revise or change later if need be. (the rate of facial implant revision is not rare and probably approximates 10 to 15%) Silastic (silicone) implants come in a wide variety of styles and sizes and are very easily revised or removed. Medpor is far inferior in these regards and its one advantage (better tissue fixation) often turns into a problem should a revision/removal be needed. The implant mobility concern with a silicone implant can be overcome by simple screw fixation,

In our practice, use only  Silastic implants for cheek and chin augmentation. We have seen multiple infections from medpor implants and  it is extremely difficult to remove Medpor without damaging surrounding tissues because of the ingrowth. Silastic implants can be easily exchanged or removed.

Though the rate of infection as reported in literature are almost the same for silastic and porous implants, in my 30 years of experience, I have much less issues with silastic. The difficulty in removing and revising porous implants require more expense, time, and additional incision on your part in case it's needed.For the fixation, with good pocket and implant design, I don't see any reason to fix the implant except for some case of jaw angle and malar (cheek) implants.

there are always advantages and disadvantages of the materials used for facial implants. Medpor materials bond to the underlying bone which can be perceived as 'good' ; but it is also 'bad' since they are hard to remove, if needed, and they can erode the underlying bone since they are dense 'plastic like' material. These implants are also more 'firm' to the feel and there is less 'feathering' into the adjacent bone so palpation is more probable but not always the case.Silastic is a 'softer' material, and depending upon the location (eg chin versus cheekbone versus jaw angle') can erode the underlying bone (chin area). They can be feathered better so less palpable. They can be removed easier since not attached to anything really. All materials can become infected and are difficult to treat if infected. A third material is 'goretex/ like material which is also a good material for certain esthetic zones. Have your surgeon discuss all these features with you