”Implantable materials have been used for many centuries in humans and there been a whole series of them tried. In today’s world, we’re using a lot of injectable soft tissue fillers, you’ve heard me talk about them, they are very exciting products, things that we can do in a very small procedure in the office and have really outstanding outcomes to address small or larger contour defects in the face and other areas of the body. What’s interesting is, the solid implants which I’ve used for more than 20 years now are still excellent options and in fact, in many cases much better options than these injectable fillers because they offer a long term solution for patients.

The most common areas for doing this are the chin, when the chin is weak or recessed back behind the lower lip and your lip and profile view should pretty much meet your chin. If you’re to look at profile view that gives you a perfect profile. In some patients you don’t need a perfect profile but if your chin is really weak where you have a deep out here at the corner, the big dipin front of the jowl, the pre jowl sulcus, those are great patients to do chin implants and get a long term correction.

These procedures can be done as outpatient with local anesthesia or local with a little sedation and light sleeping anesthesia. There’s a couple of different approaches, we can go through the inside of the mouth and have no scar if we’re going to do a little lipo under the chin, we can make a small incision underneath the chin, neither of them are visible, tiny little scars that are practically invisible under the chin and nose scar if you go through the mouth.

The other area that is commonly implanted in a long term way, which in today’s world again is being supplanted by the use of these soft tissue fillers, injectable fillers are malar implants and malar implants have a variety of different sizes and shapes that can be used and I go underneath the lip with this I create a perfect pocket size. It can be design to augment and mid-face, the lateral cheek area or the malar enhancement if you want higher cheekbone or depressed inner along the inner orbital rim, the lower part of the eyelid, all those are very good targets for using an implantable material.

They are not made of xylastic, they’re not hollow or filled with any kind of liquids so they’re not going to leak or break down overtime. In fact, in cadaver dissections I’ve done in teaching students and fellows and residents we’ve taken these implants out of 80, 90, 100 year old now cadaveric former patients and found those implants to be perfect while the tissues have deteriorated with age.

The beauty is that they’re totally removable and that they’re adjustable if we needed to have some small adjustment we can go back and do those, that’s pretty rare, in my practice the adjustment or removal rate is less than 1% over 20 years, as is the infection rate which is reported in literature to be about 3%, 3 or 4% depending on the study you’re looking at.

So as a long term solution for correction of a weak chin, what we call a micro genius small chin area or loss of definition along with chin augmenting if there’s a little more shape needed for giving volume to the mid-face that’s a long term correction as alternative to fat injections or some of the soft tissue fillers. Solid implantable materials offer an excellent option that has low risk, low complications in the right hands and it’s something that patients can rely on for the long term.

If you have any questions about injectable filler materials or more specifically our discussion point today these implantable materials please don’t hesitate to contact me DrMaas.com, you can send photographs if you want and I can morph those images with computer imaging and show you either privately or publicly if you wish to share, those images before and after and certainly visit my website at MaasClinic.com, where we have more written information about facial implants.

This is Corey S. Maas MDTM on Looking Your Best.”

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