Silicone Facial Implants, to Fixate or Not to Fixate: A Narrative Review

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Surgical Outcomes Research

Background:

• Silicone implants are widely used for facial augmentation (chin, mandible, malar regions).
• Reported complications include hematoma, infection, bone resorption, numbness, displacement, and asymmetry.
• The necessity and impact of fixation methods for facial silicone implants remain areas of investigation.

Purpose of the Study:

• To evaluate the need for facial implant fixation.
• To compare fixated versus non-fixated silicone implants across various facial sites.
• To analyze complication rates associated with different fixation strategies.

Main Methods:

• A narrative review of studies on facial implant stabilization was conducted.
• PubMed database was searched for English-language articles detailing implant location, stabilization type, follow-up, and complications.
• Eleven studies (2 prospective, 3 case series, 6 retrospective) published between 1995-2018 were included.

Main Results:

• Complications were reported for both fixated and non-fixated implants.
• Common complications included asymmetry, bone resorption, displacement, infection, and pain.
• No significant differences in complication rates were observed between fixated and non-fixated silicone facial implants.

Conclusions:

• Current evidence suggests that fixation method does not significantly alter complication profiles for silicone facial implants.
• Further research may be needed to establish optimal fixation strategies or identify specific patient factors influencing outcomes.
• The choice between fixated and non-fixated implants should consider site-specific factors and surgeon preference, given the similar complication rates.