Maxillofacial reconstruction with Medpor porous polyethylene implant: a case series study

Abstract

Objectives: The role of alloplastic materials in maxillofacial reconstruction is still controversial. Determining the utility of porous, high-density, polyethylene implants as a highly stable and flexible, porous alloplast, with properties such as rapid vascularization and tissue ingrowth, is crucial in cases of maxillofacial deformities and aesthetic surgery.

Materials and methods: Thirty high-density porous polyethylene implants were implanted in 16 patients that had been referred to a private office over a three-year period. These implants were used for correcting congenital deformities, posttraumatic defects and improving the aesthetic in nasal, paranasal, malar, chin, mandibular angle, body and orbital areas.

Results: The outcomes of the cases in this study showed good aesthetic and functional results. The majority of patients had no signs of discomfort, rejection or exposure. Two implants suffered complications: a complicated malar implant was managed by antibiotic therapy, and an infected mandibular angle implant was removed despite antibiotic therapy.

Conclusion: Based on the results, the Medpor implant seems to be an excellent biomaterial for correcting various facial deformities. Advantages include its versatility and relatively ideal pore size that allows for excellent soft tissue ingrowth and coverage. It is strong, flexible and easy to shape.

Keywords: Maxillofacial prosthesis implantation; Medpor; Reconstructive surgical procedures.

Fig. 1. Application of a “M” design malar implant and a paranasal implant. A, C. Preoperative lateral view. B, D. Postoperative lateral view. E. Preoperative view from above. F. Postoperative from above.

Fig. 2. Augmentation of malar bones using two “M” design malar implants and addressing the saddle nose with a nasal radix implant. A. Preoperative three-quarter view. B. Postoperative three-quarter view. C. Preoperative lateral view. D. Postoperative lateral view. E. Preoperative frontal view. F. Postoperative frontal view.

Fig. 3. Correction of diplopia and enophthalmous after a road traffic accident. A. Preoperative view from below. B. Medpor implant reinforced with titanium mesh for lateral wall of the orbit. C. Medpor implant reinforced with titanium mesh for medial wall of the orbit. D. Postoperative frontal view. E. Postoperative facial view from below. F. Postoperative radiography and reconstruction of medial and lateral wall of the orbit with titanium reinforced medpor implant.

Fig. 4. Using “M” design malar implant to augment malar bone combined with fat injections to the mandibular angle, ramus, and both lips. A. Preoperative lateral view. B. Postoperative lateral view. C. Preoperative view from above. D. Postoperative view from above. E. Preoperative frontal view. F. Postoperative frontal view.