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Neal D. Goldman, MD; Ramsey Alsarraf, MD, MPH; Gary Nishioka, MD, DDS; Wayne F. Larrabee, Jr, MD

Arch Facial Plast Surg. 2000;2:222-225.

Augmentation with malar implants has traditionally relied on fixation techniques such as creation of a precise pocket, external taping, and transcutaneous fixation techniques with bolsters. We present an alternate technique that fixates the implants to the rigid facial skeleton rather than to the dynamic active facial soft tissues. To avoid the use of expensive drills, we describe use of self-drilling screws for fixation of malar implants. The technique avoids transconjunctival incisions, allows wide exposure, and is presented as an alternative to traditional fixation techniques.

From the Department of Otolaryngology, Wake Forest University, Winston-Salem, NC (Dr Goldman); and the Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine (Dr Alsarraf), and The Larrabee Center for Facial Plastic Surgery (Dr Larrabee), Seattle. Dr Nishioka is in private practice in Salem, Ore.