Facial Plastic and
31350 Telegraph Rd
Bingham Farms, MI 48025
GROSS ET AL1 report a retrospective study of 264 patients who underwent Mersilene mesh (Ethicon, Sommerville, NJ) chin augmentation over a 14-year period. In their experience, this implant provided a simple, safe, and cost-effective material with excellent patient acceptance and satisfaction. This is a well-done study with good analysis.
We previously used Mersilene mesh implants for chin and nasal augmentation and would agree with the authors' favorable comments on the material. There are, however, disadvantages that outweigh some of these advantages. For us, it was impossible to create implants of truly precise dimensions owing to the nature of the mesh. One can include more sheets of varying lengths, but the final implant dimensions are not exact. As the authors mention, larger implants were extremely difficult to craft; often the correction seemed smaller postoperatively than we expected. We speculated that this resulted from some compaction of the implant during healing. Technical expertise is required to craft the implants, and they must be very carefully placed to ensure that they lie on the mandible exactly as planned. In our hands, they worked well as small, primarily anterior chin implants, but they were not as suitable for extended implants when prejowl augmentation was needed. Finally, the tissue ingrowth is both a plus and a minus. We are aware of 2 cases where a patient with a Mersilene mesh chin implant had trauma to the area more than a year later, which necessitated implant removal. Although performed successfully, the removal was difficult, and the implant was very much attached to the surrounding soft tissues including, in one case, the mental nerves.
Colton JJ. Augmentation With Mersilene Mesh. Arch Facial Plast Surg. 1999;1(3):190. doi: