Here's an anecdotal break down of the main facial implant materials. Please note this is totally anecdotal evidence (based on my years on ytf and MISSJ forum) and not the be all and end all. Also I must point out I am biased against MEDPOR. I will explain why below. but in all honesty I hate all implants but there no other alternative in some cases. Many people say were close to growing new bones but Ive spoken to one leading craniofacial doctor who said were decades away from being able to do that safely and effectively and have the ability to control the growth. Its kind of like people saying were so close to cloning hair....were decades away from that.
Silicone:
Solid Silicone is one of the oldest implant material. IMO and most doctor say it has the best long term track record of all the materials in terms of infection rates (although different papers say differently), ease of removal, and doctor familiarity. Its placed in several ways. Mostly its placed in a very tight pocket that the doctor creates. Most do it this way. Some doctors screw it in place (although one doctor claims this can increase the infection rate since it's breaching the bone, but this is just one doctors opinion). Some doctors will use sutures to keep it in place within the tight pocket (my malars were sutured in). Silicone without sutures or screws can slip out of place very easily. There was someone on YTF years ago who was training in jujitsu. Someone took him down face first on the matt and the implant literally ripped out of the pocket and slid out of place. He had a massive facial bruise from it.
BUT at the same time its very very easy to remove. You can go to any good local ps and he can remove them safely. The after effects of removal shouldnt be so bad. ease of removal can't be taken lightly. An implant can get infected ANYTIME. You don't know where you will be 10+ years from now (married with kids, unemployed, career change etc...) so you ned to be able to get help anywhere at anytime,.
After removal You will have the left over capsule/scar tissue and some indentation but for the most part your face should snap back to pre-surgery form. There was one guy who had the works with a top silicone guy on ytf jaw,chin,tear troubh,chin. He got an infection. THe doctor removed it then waited 6 months and put in new ones, he got an infection again . so they had to come out for good. He said his face pretty much went back to presurgical form, but he was in his late 20's so he was young. an older person will have more difficulty. But there was a woman on ytf who had huge silicone jaws put in. She didn't like them and had them removed. She had scar tissue but it worked out positive since it gave her more augmentation then she had prior to implants so she was happy.
It comes in different styles jaw (however the standard silicone jaw implant will only widen a jaw it wont give drop down), malar, sub malar and tear trough(tear troughs give very little projection compared to the medpor counterpart).
Silicone can look fake because of the capsule that forms around it. The bigger the implants the bigger the capsule.
Medpor/Porex
Medpor has been used for many years probably around 25-30. I believe it started out with just reconstruction then doctors started using it for cosmetic. Tissue grows through it making it very very secure(its not moving). It is also screwed in. It has a low long term infection rate (again some papers say it has a lower infection rate than silicone, while others say higher). Some people say the tissue ingrowth helps it keep infections at bay. I don't believe that because the tissue grows through it not "into it". Its not like it has a blood supply. Its not like a bone where the tissue grows and connects to it delivering blood., but again im not a dr. or an expert this is just my opinion. Medpor will not slip out of place. But at the same time removal is very hard. Many dr.s wont even touch you if you have porex especially if you had it for awhile. One story on YTF is someone had jaw implants then 10 years later wanted a bigger set. The doctor said he will remove them and replace. On the table the dr. wasn't able to remove them without breaking the jaw so just stacked them on top of each other. Another story is someone went to a dr. to have them removed only after a few months. the dr. said sure. on the table the doctor couldn't get it out so he just brought the guy out of anesthesia and said he couldn't do it. THeres one woman who was able to have her medpor cheeks removed but the doctor had to cut around the implant to get all that ingrowth out. Now shes left with major aesthetic indents and issues that cant be fixed easily. Now there have been successful cases of people getting there medpor removed. One guy went to korea and had paranasals removed successfully with no issue. Someone had a nose implant removed somewhat easily although the doctor removed a ton of tissue. BUT Dr. ramirez did tell me that hes put them in boxers who continued to box and proffesional football players and wrestler so you never have to worry about them slipping or discontinuing any physical activity which you would have to stop if you got silicone. BUT most local plastic arent that familiar with the stuff if you get an infection (although low chance) you are in trouble. You have to find a doctor willing to remove it and it wil probably cost a lot because its a tough job for the doc. Thats if your still able to move around and have the $$. If your really seriously infected your going to the ER and then the cranio or plastic on staff will have to remove it. His first and only goal will be safe removal .Hes not going to care about aesthetics.
they come in many different types jaw (which can give drop down ,or flare out ,or both), malar, and orbital rims upper and lower and gives far better augmentation than the silicone version. Ive seen peopl vhave theyre face transformed for the better with medpor (havent realy seen such profound changes with people who had all silicone).
Mepor implants resemble bone more then silicone and due to the ingrowth there no huge capsule that forms.
Composite (silicone covered in gore-tex)
While goretex and silicone have been used in the body for year the composite facial implants have only been used for around 15 years. Infection rate for gore-tex and silicone as stand aloine are low but combines imo its unknown. I havent found any papers discussing it. Its either placed in a pocket only or screwed in. Its removal is harder then regular silicone but easier then medpor. The gore-tex coating is only around .3mm so there no ingrowth just "attachement" per the company rep who I spoke with. To date I havent known anyone on any board who has it. A lot of doctors who used to use medpor are switching over to this because medpor no longer makes custom implants. Only the pre-fabricated ones are available.
They come in the same style as the regular silicone but can be made custom. Ive spoken to a few surgeons who said removal isnt a problem BUT i dont know any removal stories so who knows.
PEEK
This is a new material has been used in soine surgery for last 10-11 years. Doctors started using it sine 2007-2008 for custom facial implants. I have heard its expensive to use but the cost is lowering. It doesnt have a long term infection history . The one paper I read tracked people who had it since 2008 and no infection. Its supposedly the future. Its easy to remove because there no ingrowth. Can be screwed down and looks like bone. Can be easily customized.
Again each has pro's and cons. Its up to you to decide. One thing I do recomend is whatever material you do have a "go stick". Get a copy of the surigcal report, how it was placed, style of implant (if custom a design) and a ct or cone beam scan. Keep it on a usb stick that way if you ever do have an issue down the road you have an "intelligence report" to give the dr. helping you so he's not toally blind.
