Complications of alloplastic facial skeletal implants in aesthetic surgery: A systematic review and meta-analysis

This study aimed to evaluate the effectiveness of various alloplastic facial implants in correcting facial defects based on post-operative complications and failure rates in patients who underwent facial skeletal augmentation.

A comprehensive search for articles reporting relevant articles was using Google Scholar and PubMed databases. Data from publications that satisfied the predefined inclusion criteria were synthesized and analyzed using OpenMeta [Analyst] software.

A total of 48 studies with a population size of 3701 patients who received 4139 alloplastic facial implants were included in this analysis. The complication rate was 10.7% (95% confidence intervals [CI] [8.3%, 13.2%], and I² =89.35%). Paranasal implants had the highest rate of complications of 15.1% (95% CI [7.8%, 22.3%], and malar implants had the lowest complication rate of 7.4% (95% CI 3.8%, 11.1%]) I² = 72.62%). In 15 studies that had malar implants, 853/1788 (45.8%) of the patients received malar implants (95% CI [0.356, 0.561]). In 8 studies that included mandibular implants, 265 (56%) of 508 patients received mandibular implants (95% CI [0.474, 0.645]); in 11 studies, 371/489 (76.1%) received nasal or paranasal implants (95% CI of [0.565, 0.912]), while in 3 studies, 14/15 (85.5%) received frontal implant (95% CI of [0.645, 0.997]). In 17 studies that investigated the use of chin implants, 1366/1366 (100%) of the eligible patients received chin implants (95% CI [0.995, 1.000], I² = 0%). The complication rate was 2.78% for silicone, 1.02% for calcium hydroxyapatite, and 2.48 for Medpor.

Alloplastic facial implants are a viable alternative to enhancing facial beauty and performing facial skeletal augmentation with a relatively lower risk of complications associated with all facial implants.