Complications of cosmetic malar augmentation are uncommon. We describe the unusual case of a 60-year-old woman who experienced vision disturbances (flashing lights and diplopia) while masticating. Ten years earlier, she had undergone bilateral malar enhancement with silicone implants. Imaging studies revealed that the implant on the right side had become displaced. The prosthesis had entered the orbit in the retrobulbar area and eroded the lateral zygomaticomaxillary buttress and the orbital floor. Both implants were removed, and the patient's symptoms immediately resolved. To the best of our knowledge, no case of vision changes secondary to erosion of the posterior orbit by a silicone malar implant has been previously described in the literature.
Malar augmentation is a common cosmetic procedure that aims to accentuate the malar prominences, an important feature of Western beauty.1 Malar augmentation improves the appearance of a person with a flat malar eminence, and it also creates a younger appearance. Alloplastic implants are the most common material used for this augmentation, and they are generally considered safe and reliable.