Reconstruction in the head and neck frequently requires the use of additional autologous or alloplastic material to replace any defects that may have occurred following the loss of tissue from trauma or cancer removal. Frequently, there is limited autologous tissue to be used to reconstruct these defects, and alloplastic materials offer an appealing alternative that can be used as well. These implants are used to reconstruct multiple facial defects, including those of the ear, nose, chin, and orbit.1- 4 Two such commonly used alloplastic implants are expanded polytetrafluoroethylene (e-PTFE, or GORE-TEX; W. L. Gore Associates, Flagstaff, Arizona) and porous high-density polyethylene (Medpor; Porex Surgical Inc, Newnan, Georgia). These implants are tolerated by the body owing to their porosity (Figure 1), which allows host tissue integration with fibrovascular ingrowth into the pores of the implant as well as lack of host tissue reactivity to the implant.5- 6 The pores in the GORE-TEX are 20 to 30 μm in size, and the pores in the Medpor are 150 to 200 μm. Because these implants do not have their own blood supply, one of the main concerns is the risk of exposure to bacteria that are in the region of the implant when it is placed in the body. Sclafani et al7 found that, when implanting GORE-TEX and Medpor, if there was bacterial contamination at the time the implant was placed, then 100% of the GORE-TEX and Medpor implants became infected. It is hypothesized that this occurs because there has not yet been fibrovascular ingrowth of the body tissue into the implant, and so there is no blood supply to carry intravenous antibiotics or host antibodies or other cellular immune entities to fight any bacteria that may have contaminated the implant during reconstruction process. Once bacteria have contaminated a foreign body, then it usually needs to be removed because it cannot be sterilized and will lead to extrusion. To try and prevent infection under these circumstances, surgeons have empirically exposed implants to antibiotics to try and eliminate any bacteria that may have contaminated them during the implantation process. The use of alloplastic material preimplated with antibiotics is not a new tool and has been described in orthopedic surgery, where the cement can be impregnated with an antibiotic.6,8- 10 The disadvantage to preimplanted antibiotics is that if the patient has a sensitivity or allergy to them and this fact is overlooked or unsuspected,11 difficulties might arise. In addition, it would not be realistic or cost-effective to put a broad spectrum of antibiotics into a variety of alloplastic implants that would be used in different bacterial milieus or in patients who may have an allergy and to keep these stocked for use when urgently needed. A more practical approach would be to place a selected antibiotic into a particular implant when needed. The senior author (M.A.K.) has personally witnessed and used several different techniques in attempting to infiltrate selected antibiotics into porous alloplastic implants during head and neck reconstruction, but we were not able to identify any specific studies performed to determine the most effective methods to accomplish this. Multiple different techniques have been reported to try and infiltrate antibiotics into the implant, including just dipping the implant into the antibiotic, completely immersing the implant in the antibiotic, and, finally, applying negative pressure to create suction and infiltrate the implant with the antibiotic. To our knowledge, there have been no formal studies performed to evaluate these different intraoperative techniques and determine their effectiveness for antibiotic infiltration into alloplastic implants. Our study evaluates several techniques with an in vitro model using bacterial growth inhibition (GI) to determine the optimal technique to infiltrate antibiotics into the GORE-TEX and Medpor alloplasts so that they may function as delayed antibiotic delivery devices, theoretically decreasing the risk of infection in facial reconstruction.