High-density polyethylene facial implants show surface oxidation in SEM and EDX examination: a pilot study

Previous histopathological studies on explanted Medpor high-density polyethylene (HDPE) facial implants indicated signs of material destruction and claimed to observe phagocytized HDPE particles within the tissue samples beside the usual type IV reaction with severe fibrosis. We examined new and explanted Medpor material with scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX). The implant surface of three patient-derived specimens showed significantly higher oxygenation in EDX analysis and morphological changes in SEM compared to the new unused material directly after opening of the package and after 1 year of exposure to air. Our preliminary findings indicate a possible oxidative biocorrosion in HDPE surgical implants. Further studies should confirm these pilot project results.