EP.FRI.749 Facial augmentation surgery: Perception vs. Reality

Background In recent years, aesthetic surgeries have gained significant momentum. A recent audit identified that more than 28,000 cosmetic surgeries were performed in the United Kingdom (UK) in 2018.1. We present an unfortunate case of morbid complications related to the use of malar implant for cosmesis. Case Presentation A 63-year-old Caucasian female presented to the Emergency department with sepsis related to a large painful, tender swelling of the right side of the face. There was discharge of pus from two cutaneous sinuses with additional ectropion/chemosis of the right eye. An orocutaneous communication due to infection/migration of the implant was also noted. The patient reported a history of bilateral malar implants placement three years ago. The patient initially required emergency drainage & subsequent removal of the infected malar implant. Discussion Malar implants provide suitable volume enhancement providing structural and aesthetic benefits including the ‘high cheek bone’ appearance. It is generally considered to be a safe surgical technique with multiple approaches possible to insert the implant. including transoral approach). Spadafora (1971) & Hinderer (1972) first described the use of malar implants for facial augmentation.2,3 Rayess et al.(2017) conducted a 10 year review of complications related to facial implants & noted that 75% of complications related to malar implants were due to infection with 38% of these implants needing removal.4 Conclusion There is a surge in presentations of complications related to cosmetic facial surgery and knowledge of these adverse effects is essential to appropriately manage these patients & their concerns.