A common problem with every shape and size of malar/cheek implant is movement, either immediate or delayed, from its desired position on the malar bone. Once the pocket has been created and the implant inserted, suturent bolsters must be tried with limited success to prevent immediate slippage of the implant. Postoperatively, delayed implant mobility can occur anytime and is particularly annoying to the patient when the cheek is palpated. From the success of miniplating of facial fractures, a technique has been developed that allows the immediate, permanent fixation of the silastic implant to the facial skeleton with stainless steel screws.
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