An unusual complication of malar augmentation.

The purpose of this report is to describe an unusual complication of aesthetic alloplastic malar augmentation and to provide a brief review of the literature regarding this complication, its treatment, and its prevention. We review the case of a single patient who presented with a delayed malar pneumatocele after undergoing bilateral malar augmentation using rigid titanium screw fixation complicated by an anterior maxillary sinus wall defect. Although an effective and efficient method, rigid screw fixation is not without potential complications as evidenced by the currently reported implant-associated malar pneumatocele. Care should be taken to avoid damage to the maxillary sinus wall during fixation and, if encountered, the procedure should be aborted, the defect repaired, or a nonporous implant placed with postoperative counselling given to the patient.