Cheek drooping in 2 patients with maxillary fractures after rigid fixation with bioabsorbable mesh

Bioabsorbable plate-screw systems are commonly used for the internal fixation of facial bone fractures. The anterior maxilla has a unique curved shape, and fractured bony fragments tend to be small and fragile; therefore, more effective rigid fixation can be achieved using a molded bioabsorbable mesh rather than a bioabsorbable plate. Herein, we describe 2 patients with cheek drooping after a rigid fixation of comminuted maxillary fracture using bioabsorbable meshes and screws.The postoperative courses were uneventful, but both showed soft tissue bulging in the cheek area of the operation site for 12 to 13 months after the operation. No other symptom or sign related to inflammation or foreign body reaction was noted.In comminuted maxillary fractures, bone fragments are more conveniently fixed with a 1-piece molded bioabsorbable mesh. However, it is believed that a single large mesh may interfere with adhesion between the maxillary surface and the overlying soft tissue. Therefore, we recommend using the least amount of mesh to fixate maxillary bone fragments.