Intraorbital erosion of a malar implant resulting in mastication-induced vision changes

Complications of cosmetic malar augmentation are uncommon. We describe the unusual case of a 60-year-old woman who experienced vision disturbances (flashing lights and diplopia) while masticating. Ten years earlier, she had undergone bilateral malar enhancement with silicone implants. Imaging studies revealed that the implant on the right side had become displaced. The prosthesis had entered the orbit in the retrobulbar area and eroded the lateral zygomaticomaxillary buttress and the orbital floor. Both implants were removed, and the patient's symptoms immediately resolved. To the best of our knowledge, no case of vision changes secondary to erosion of the posterior orbit by a silicone malar implant has been previously described in the literature.