Natural And Synthetic Grafts And Implants Used In Facial Plastic Surgery

Natural and Synthetic Grafts and Implants Used in Facial Plastic Surgery

There are several procedures in facial plastic surgery that require a graft or implant to create the ideal results for a patient, including chin and cheek augmentation, rhinoplasty, and fat transfer. Thanks to the advances in plastic surgery over the past couple of decades, patients and surgeons now have different options for the type of material used for the graft or implant.

Here is a general overview of the various natural and synthetic materials used in facial plastic surgery as well as their positive and negative attributes.

Natural Materials

1. Patient cartilage – This is usually one of the go-to options for plastic surgeons when choosing a natural graft. The cartilage can be taken from the patient’s ear or rib and then worked into the correct shape for the procedure.
1. Benefits – The material is coming directly from the patient, so there are no foreign substances being introduced into the patient’s face. This greatly reduces the risk of complications and the possibility of graft rejection. Harvesting the cartilage doesn’t cause any major changes to the source, so there won’t be a need for additional surgery to fix the patient’s ear or rib. Cartilage is also a source that is easily accessible to the surgeon.
2. Disadvantages – Cartilage is a tough, fibrous material that is difficult to manipulate into specific shapes. Once the graft becomes accepted into the host site, it’s really hard to move, which could create problems if adjustments or corrective surgeries are required down the road. Harvesting the cartilage from the patient also creates an additional recovery site after the procedure is over.
2. Patient fat – Similar to the cartilage graft, fat grafts come from fatty material that is taken from the patient before it is refined and then injected at the target site to add more volume and contouring to a patient’s face. Fat cells are usually harvested with standard liposuction at the patient’s hips, tummy, thighs, or buttocks.
1. Benefits – Like cartilage, fat is a material that comes from the patient. It’s easily moved and transferred in case touch-ups or additional areas need some help. There is also no assimilation needed between the graft and the host site because you have fat throughout your entire body. Recovery from fat grafting is extremely minimal at the host site.
2. Disadvantages – The area where the fat is harvested will need to have some healing time, so there will still be some recovery involved in the procedure. Fat grafting also requires a little extra prep work on the part of the surgeon to ensure that quality cells are selected for the injections.
3. Diced Cartilage Fascia (DCF) – This is a more advanced version of the cartilage graft that involves cutting a patient’s cartilage into tiny pieces and then wrapping them all up inside of a piece of muscle fascia to keep them together.
1. Benefits – Unlike plain, untreated cartilage, DCF grafts are easy to shape and manipulate, giving the patient more natural-looking results.
2. Disadvantages – Patients have a greater chance of swelling around the graft during the recovery period. There is also a chance that the graft will lose it shape over time as it is absorbed by the body at the host site.

Synthetic Materials

1. Gore-Tex – This is one of the most recent options available in facial plastic surgery. Gore-Tex is a very tough and durable material (it’s essentially Teflon) that’s typically used as an implant for rhinoplasty and chin augmentation.
1. Benefits – Gore-Tex is easily customizable to the individual patient and is capable of integrating with the patient’s existing tissue once it’s inserted. It has a low risk of infection and rejection, plus it also has a higher positive track record than other synthetic implants.
2. Disadvantages – Once the implant integrates into the existing natural tissue, it is very difficult to remove or shift its position. There is also a chance of bacteria growth under the implant. Over time, Gore-Tex implants can also poke through the skin.
2. Silicone – Easily one of the most commonly used materials for synthetic implants in plastic surgery, and not just for facial procedures. Silicone implants can have a hard outer shell that is filled with silicone gel, or they can be made into a tough, rigid shape.
1. Benefits – Silicone has a long history of being used in cosmetic procedures, so your surgeon is more likely to have experience with the material. Silicone implants also have a higher degree of flexibility and can be removed, replaced, or repositioned with ease.
2. Disadvantages – Silicone also has a history of patient rejection or infection. It can’t ingratiate itself with the body’s natural tissues, so it has a chance of moving around within the body or changing its shape.
3. Dermal Fillers – There is a wide variety of dermal fillers on the market available to plastic surgery patients. Things like Botox, Juvederm, Restylane, and Perlane can be used to reduce or eliminate wrinkles, give your face a little more structure and definition, and increase the volume of different areas of your face.
1. Benefits – Dermal fillers don’t require surgery, so they are significantly less expensive and don’t have a major recovery time.
2. Disadvantages – Dermal fillers aren’t permanent and need to be reapplied about once a year. There are also limitations to what the fillers can achieve; sometimes surgery will actually be a better option.

This is by no means a comprehensive list, but it should give you an idea of the types of materials used by doctors in facial plastic surgery. Each doctor has their own preferences, but a good surgeon will have knowledge and experience in both natural and synthetic materials.

To learn more about your own individual options for facial plastic surgery, contact Dr. Paul Nassif at (310) 275-2467 to schedule an initial patient consultation.