Se. Metzinger et al., Malar augmentation - A 5-year retrospective review of the silastic midfacial malar implant, ARCH OTOLAR, 125(9), 1999, pp. 980-987
Objectives: To determine the effectiveness and safety of the Silastic midfa
cial malar implant and to review indications, patient selection, technique,
and complications of malar augmentation.
Design: Five-year retrospective review of clinical cases with at least 2-ye
ar follow-up.
Patients: A cohort of 60 consecutive private patients with complaints of ma
lar hypoplasia or facial asymmetry.
Setting: A plastic surgery clinic.
Intervention: Silastic midfacial malar implants were fitted in each patient
. Most underwent implantation via the canine fossa approach and in conjunct
ion with another facial plastic procedure.
Main Outcome Measures: Subjective patient satisfaction, photographic gradin
g using a visual analog scale, and complications.
Results: Of the 60 patients, 51 (85.0%) reported an excellent result after
at least a 2-year follow-up. Ten patients (16.7%) had some form of undesira
ble sequelae; however, only 4 (3.4%) of 118 implants had to be revised. Pho
tographically, all 60 patients graded postoperative improvement.
Conclusions: Findings support the contention that the Silastic midfacial ma
lar implant is a safe and effective alloplastic alternative to treat malar
hypoplasia and facial asymmetry. The complication and revision rates are ac
ceptable. Relative technical ease of insertion makes malar augmentation an
excellent adjunct for rhytidectomy and rhinoplasty.