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

Silicone implants are one of the most widely used implants for facial augmentation, especially in the chin, mandibular angle, and malar area, utilizing different surgical approaches. Despite their various advantages, many complications have also been reported, including hematoma, infection, bone resorption, numbness, displacement, and asymmetry. This study aims to evaluate the need for facial-implant fixation and compare and contrast fixated and nonfixated facial silicone implants in different facial sites. A narrative review of the topic of facial-implant stabilization using the PubMed database inclusion criteria included articles that discussed the topic of facial implants, were published in English, and included critical information such as the location of the implant, type of stabilization, follow-up periods, and complications. A total of 11 studies were included. Of these, two were prospective clinical studies, three were case series, and the remaining six were retrospective clinical studies. The studies were published between 1995 and 2018. The sample size varied from 2 to 601 cases. Stabilization includes suturing, monocortical screws, or no stabilization. Complications were reported in most of these studies, including asymmetry, bone resorption or erosion, displacement, dissatisfaction, edema, hematoma, infection, mucosal irritation, pain, and paresthesia. The follow-up period ranged from one month to 17 years. Despite the varied settings of these studies, silicone facial implant complications were reported in both fixated and nonfixated implants, with a lack of significant differences between fixated and nonfixated facial silicone implants regarding the method of fixation.