Commentary on: Alloplastic Augmentation of the Asian Face: A Review of 215 Patients.

Abstract

It is human nature to avoid responsibility when faced with unfortunate outcomes. Blame the gun, not the perpetrator; blame the implant, not the surgeon. Hence, as the authors of this article point out, alloplastic facial implants have been demonized by many in the plastic surgery community. To their credit, the authors document that, with appropriate technique, facial implants can be safe and effective.1 Using the same basic principles as the authors, but with some different personal preferences, I too have found facial implants to be effective with few complications. This commentary provides the opportunity to emphasize the important commonalities in our use of facial implants and mentions variations and preferences that I have found useful. Implant materials used for facial skeletal augmentation in the United States have been approved as safe and biocompatible by the federal Food and Drug Administration. They have an acceptable reaction between the material and the host. In general, the host has little or no enzymatic ability to degrade the implant with the result that the implant tends to maintain its volume and shape. Likewise, the implant has a minimal and predictable effect on the host tissue that surrounds it. Hence, implant materials per se do not have toxic effects on the host. Implant materials differ in their surface characteristics. …