What is Facial implants?

Facial implantation or augmentation is done for reconstructive or cosmetic purposes. It has become increasingly popular for the 'normal' everyday person to seek facial augmentation to remove or improve existing acne scars and facial lines or to enhance a specific facial area.

Over the years many filling (implant) agents have been developed. However, the search is still on for the ideal facial implant material. The ideal product should have the following properties:

• physiologically acceptable: incorporates itself with the body's tissues
• free of complications or side effects
• permanent: does not degrade with time
• easy to use: simple and quick procedure, e.g. injectable.

What are facial implants used for?

Facial implants can be used in reconstructions for areas that may have been scarred or altered by trauma. This may be done in conjunction with minor or major plastic surgery. The other increasing use of facial implants is in cosmetic surgery where patients seek these treatments to improve their appearance.

They are mainly used for the removal or improvement of scars caused by acne, correction of facial (wrinkle) lines, and enhancement or "filling in" of certain specific facial features such as the lips or chin.

Facial lines and features that can be corrected using implants

• Frown lines (glabellar lines)
• Smoker's lines (perioral lines)
• Marionette lines (oral commissures)
• Worry lines (forehead lines)
• Crow's feet (periorbital lines)
• Deep smile lines (nasolabial furrows)
• Smile lines (nasolabial lines)
• Cheek depressions
• Lip enhancement
• Witch's chin (chin augmentation)
• Acne scars
• Facial scars

What products are available?

There are numerous implant substances that add bulk to tissue. Manufacturers of these products will claim theirs to have certain advantages over others. The decision as to which you should use will depend on what you are trying to achieve and on the expert advice of your dermatologist. Each has their place and specific uses in facial augmentation. See individual implant types for specific details regarding use. The list below includes some older products that are no longer in general use.

Implant type	Product names
Fat grafting
Collagen	ZydermTM, ZyplastTM, AllodermTM, CosmoDermTM, CosmoPlastTM
Hyaluronic acid	HylaformTM, RestylaneTM, CaptiqueTM, PerlaneTM, JuvedermTM, PrevelleTM, PuragenTM, ElevessTM
Hydroxyapatite	Hydroxyapatite (HA), Coralline Hydroxyapatite (CH), RadiesseTM
Silicone	Popular manufacturers include Implantech, Allied Biomedical, Advanced Bio-Technologies, Inamed Aesthetics
Expanded polytetrafluoroethylene (ePTFE)	Gore-TexTM, SoftFormTM
Polyethylene	MedporTM
Polymethyl-methacrylate (PMMA)	ArtecollTM, MetaCrillTM, ArtefillTM
Hydrophilic polyacrylamide	HydrogelTM, HPGTM, ArgiformTM, BioformacrylTM, DermaLiveTM, AquamidTM
Poly-L-lactic acid	SculptraTM

Of the implant types described above, the following are injectable augmentation products:

• Collagen (excluding Alloderm®)
• Hyaluronic acid
• Polymethyl-methacrylate (PMMA)
• Hydrophilic polyacrylamide gel
• Poly-L-lactic acid

These products provide facial augmentation with less downtime. Collagen and hyaluronic acid provide only a temporary solution as they are reabsorbed into the body over time (3 to 12 months); top-up treatments are necessary to maintain the desired correction. PMMA and hydrophilic polyacrylamide gel are recent additions of injectable augmentation products and give more long-lasting results (months to years).