Malar augmentation: a 5-year retrospective review of the silastic midfacial malar implant.

[OBJECTIVES] To determine the effectiveness and safety of the Silastic midfacial malar implant and to review indications, patient selection, technique, and complications of malar augmentation.

[DESIGN] Five-year retrospective review of clinical cases with at least 2-year follow-up.

[PATIENTS] A cohort of 60 consecutive private patients with complaints of malar hypoplasia or facial asymmetry.

[SETTING] A plastic surgery clinic.

[INTERVENTION] Silastic midfacial malar implants were fitted in each patient. Most underwent implantation via the canine fossa approach and in conjunction with another facial plastic procedure.

[MAIN OUTCOME MEASURES] Subjective patient satisfaction, photographic grading using a visual analog scale, and complications.

[RESULTS] Of the 60 patients, 51 (85.0%) reported an excellent result after at least a 2-year follow-up. Ten patients (16.7%) had some form of undesirable sequelae; however, only 4 (3.4%) of 118 implants had to be revised. Photographically, all 60 patients graded postoperative improvement.

[CONCLUSIONS] Findings support the contention that the Silastic midfacial malar implant is a safe and effective alloplastic alternative to treat malar hypoplasia and facial asymmetry. The complication and revision rates are acceptable. Relative technical ease of insertion makes malar augmentation an excellent adjunct for rhytidectomy and rhinoplasty.