Complications of static facial suspensions with expanded polytetrafluoroethylene (ePTFE)

Background: Expanded polytetrafluoroethylene (ePTFE) is a synthetic porous material that has been used for static suspension in facial paralysis. It i s manufactured in thin (1-mm or 2-mm) sheets that can be cut into strips an d implanted through keyhole facial incisions. Regional deformities are addr essed by multiple suspensions that provide cosmetic and functional therapy. The use of ePTFE eliminates donor site morbidity associated with the tradi tional harvest of fascia from either the temporal area or fascia lata. Howe ver, properties unique to this alloplast contribute to the complications th at have occurred after its use in facial reanimation. Objective: To describ e complications with the use of ePTFE for facial suspension. Setting: Acade mic medical center. Method: Retrospective chart review and review of litera ture. Results. Six patients with facial paralysis who were treated with the ePTFE sling procedure had complications. Five slings failed because of str etch despite prestretching at implantation. One patient developed a late wo und infection requiring removal of the sling. Conclusion: An ePTFE facial s ling is an option for static facial suspension that can be therapeutic for patients with seventh nerve damage. There is a high rate of complications l eading to revision surgery. Future studies are needed to evaluate alloplast ic alternatives to ePTFE.