Thank you for
your question.
You submitted your question without a photo.
And you state that you had cheek implants removed after 1 month due to infection in
both of them.
And you state that it’s certainly rare for this to occur and you have some concerns.
You’re concerned on whether or not you have some underlying issue with your body’s defense
and you’re looking for some degree of explanation.
And in your question, you’re saying you’re falling into a depression about this event.
Well, in the absence of knowing your full medical history or any other important details,
I can give you some general ideas about what I would consider when something like this
happens.
And something that you should also understand about what the risks are when you place any
type of foreign of substance in your body.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Facial implants as well as body implants is something that has been a big part my surgery,
practiced for this time.
This includes cheek implants, chin implants, breast implants.
And I can certainly tell you that there are so many variables that are important and can
be somewhat related to what has occurred in your situation.
But let’s start with the simplest.
The reality with cheek implants is we’re actually going through the mouth and that’s
just the standard procedure.
And the reality is that the mouth, even with extensive cleaning prior to the surgery and
placing patients on antibiotics before surgery, we refer to this as a dirty area.
This is an area where naturally there’s lot of bacteria.
So when the implant is placed and once the implant is placed and fixated, and not only
do we also irrigate that area with antibacterial solution, the placement of stitches in a way
is to allow for any type of drainage to occur so that anything going on in the inside can
drain out.
That being said, there is a potential risk.
An implant doesn't have a blood supply.
And so it’s common for a lot of times, just the most routine, what’s called bacteremia
where bacteria is in your blood such as when you brush your teeth, it can potentially seed
the implant and cause this type of infection.
This can happen to a cheek implant, it can happen to a chin implant, it can happen to
a breast implant.
It can happen to injectable fillers.
You can place an injectable filler and nothing happens until suddenly, somebody can develop
an injection.
With injectable fillers, we also think about the bacteria on the skin and going in even
with good cleaning and causing something called a biofilm.
And so whatever we do with medicine, when we’re crossing a natural barrier, there
is the risk of infection whether it’s from the time of the surgery, whether it’s from
routine daily life.
And in addition, there’s also a greater colonization of people’s respiratory tracts
and bodies with relatively resistant bacteria.
I think this particularly applies to people who work in healthcare, working in hospitals
and other areas where there’s a lot of use of antibiotics basically isolates a lot of
resistant bacteria.
And so it’s become part of my routine to discuss with patients who work in hospitals
about the relative risk of infections whether it be MRSA or any other type of infection
that can be due to just being in that environment and being colonized.
We live in a very interesting time where antibiotics, whether it’s being used liberally in the
medical field or used in the food products and the things that we take in has changed
a lot and created a lot of risks relative to infections.
Even when you’re not doing implants, you can still get infections with any surgery.
That being said, I would say that it’s of course appropriate for you to discuss this
with your medical doctor.
Have your medical doctor do routine lab tests and just make sure that you are otherwise
healthy.
I would also say that you don't want to just give up.
I think that there is still a potential opportunity for you to consider enhancing the cheeks not
necessarily with implants but maybe something with injectable fillers.
And the reason why I’m saying that is that injectable fillers such as those in the hyaluronic
acid filler family such as Juvederm Ultra Plus, Juvederm Voluma, these are long lasting
fillers that has become a major part of my own practice as a significant alternative
to implants.
I find myself gravitating towards doing things such as these because of the control, the
ease and the convenience for our patients.
And when it comes to concern of course of potential infection, I think that it’s important
that you bring that information to the prospective doctor.
When we do this procedure, I actually do something called Structural Volumizing.
And we do this like in a way when we do surgery.
We do everything in a super sterile technique, we clean in a way as if we were doing a surgical
procedure even though it’s done in an exam room and place the filler using special instruments
at the bone level so that you can get this nice natural enhancement without looking overly
done comparable to a cheek implant.
The other thing that’s really nice about this method if you were to have an infection,
it’s not a surgical solution.
We can actually dissolve the filler with an enzyme called hyaluronidase.
And once the foreign body as what I discussed earlier is gone which is the filler, then
the bacteria has nothing to live on top of.
So I think that you should allow yourself a chance to heal after this procedure.
Discuss this with the doctor who performed your surgery and trust the option of having
the cheek fillers as opposed to another surgery.
But again, it’s a matter of discussion with you and your doctor.
So I hope that was helpful, I wish you the best of luck and thank you for your question.