Midface volume replacement with a transmaxillary implant

Volume replacement is an essential component of midface rejuvenation. Previously designed alloplastic implants augment bony prominences. The Maxout implant was configured to add height to the lowest surface, the canine fossa.

A random series of patients, from an office-based practice requested midface augmentation. Three of these patients were human immunodeficiency virus (HIV) positive. With the patient under local anesthetic, bilateral Maxout implants were inserted through either an intraoral or an intranasal incision.

All the implants produced a satisfactory aesthetic improvement. In one HIV-positive patient, one implant placed intraorally became infected and required removal. It was replaced 3 months later through the transnasal approach. All the patients had retained their implants 1 year later.

The Maxout implant is easy to insert and remove, aesthetically effective, secured by bone structures, and located in a neutral position. The risk of infection must be considered, especially for HIV-positive patients.