Facial implants are medical supplies used for corrections of facial and mandibular bone shape and volume disorders that congenitally exist or caused by past traumas or surgery, aging. Without interfering directly to bone structure, they are placed over bones and desired shape and volume is obtained. Mostly they are placed to mentum and zygomatic area. The bone structures that give face its shape are cheekbone (zygoma), upper jawbone (maxilla) and lower jawbone
(mandible). In an ideal face, distances between forehead hairline and nasal beginning level; nasal beginning level and tip of the nose; the tip of nose and the tip of mandible should be equal. Space between two lips and tip of mandible should cover 2/3 of the space between tip of the nose and the tip of mandible. Bone structure provides that ratio with soft tissues of the face. Mandibular and maxillary shape and volume disorders may cause defects to closure of teeth. Orthodontic treatments must be done in early ages in these cases. Comprehensive surgeries for jawbones called ortognatic surgeries can be necessary after bone growth is completed. If bone deformities don’t cause difficulties to teeth closure or they have been fixed with orthodontical treatment in adult patients, giving the face more rational and aesthetic appearance is possible with facial implants. In facial implants silicon and porous polyethylene formed materials are preferred. Porous polyethylene (Medpor) implants are shaped by shaving with lancet or shaving techniques on operation and desired contours are obtained.
How are facial implants applied?
Facial implants are applied with local anesthesia and sedation if it will not be combined with another surgery or with general anesthesia in operating conditions in hospitals. Implant for zygomatic bone is placed from incision that is made to the sulcus over upper teeth in the mouth. This mucosal incision heals fast with no scars. Implant for mandibular area is placed from a single incision that is made to sulcus beneath lower teeth at the midline, in the mouth. On some patients a horizontal incision of 3-4cm made under jaw is preferred for placement of the implant. Implant is placed on the bone to a pocket that is created under periosteum. It can be fixed to bone with a screw if required. A skin bandage applied to the area where the implantation is done. Regular cold application is used like other facial operations.
How is postoperative phase of facial implant operation?
Patient is discharged the same day or the next day with an antibiotic, analgesic and a mouthwash prescription. Patients are asked to sleep with an elevated back on first week. Swelling of the area that facial implant is placed begins to decrease rapidly from the first week. Most of the swelling should be gone by the end of 6th week. Facial contour takes its latest appearance in 6 months to 1 year. Prosthesis can be felt on first months on some patients especially with a strong palpation. There can be numbness on the operated area and weakness of mimic muscles. All these are temporary
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