Complications in aesthetic malar augmentation

The complications of malar augmentation with prosthetic materials are few. The majority are related to incorrect choice of prosthesis size or position. No complications of tissue damage have occurred, but the two instances representing delayed infection may have been a result of seeding of the capsular space from the structures in the oral cavity abetted by what appeared in one case to be the remnant of an old hematoma. Preventable complications include the use of posterior Dacron fixation for gel prostheses, since the elongated or extended malar prosthesis may not resist the forces of capsular contracture in all instances. Patient acceptance has been extremely high in 35 cases, and removal has been requested in only one instance, reflecting the value of preoperative counseling with diagrams, photographs, and drawings.