make your own bone wider instead of cutting it

[Rico]

In Italy one clinic use kinda hydroxyapatite based substance which changes into your own bone with the time.

They just make for example malar graft and cover it with this substance,, and you have "wider bone" (your own) in this place after some time.
What you think about it ?  Have you heard about it ?

in Europe only this clinic use it, perhaps one other more. it's rare solution (as I suppossed)
I saw examples and was impressed. and this procedure is much less risky than osteotomy

[Rico]

hmm I'm little confused now. because some say that this is common solution, but I first time hear that such implant from hydroxyapatite is going to change into bone

there is no link... I just had consultation ... find Prof Nocini (and his team) researches , etc  ..

now I wonder if hydroxyapatite can be used in many ways ...

those who has HA paste or something like that.. is that changed into your bone ?
anyone know what is going here in this topic ?

[Rico]

I started to see the difference

http://www.dermnetnz.org/procedures/hydroxyapatite.html

"Over time they are partially resorbed and replaced by natural bone."  I wonder what does it mean "partially" ..

so in summary, HA paste and HA solid implant are not the same things. Did you know that ?
any surgeon has given you such option

[PloskoPlus]

This is actually "invented " by a doc in Australia, I believe.  He uses this mainly for the orbital rim, cheek and chin areas.  I know two females that got this done by him and the results are alright. To remove this stuff will be hassle because no one in the states likes to or wants to remove it but the Aussie doc states it's fairly easy to scoop out- so I guess that's what it means by "partially"? 

As far as reabsorption goes, I think it gives subtle changes. I suppose if that's the change that you want- give it a try.

If he's the person I think he is, then he's full of s**t, and just reinvented the HA paste wheel.  (No need to mention his name, this site does not need lawsuits).  HA paste is a bad idea.  It's been around for a long long time.  There is a reason why nobody uses it.

[Rico]

Plosko we do not  talk about HA paste, but HA SOLID implants.  The link I gave is just random text...has nothing to do with the surgeon I talked.

what I understand this implant become integrated with bone...and Hydroxiapatite is natural component of the bone..so after some time many molecues become typical bone molecules..  Don't forget that in bones there are kinda vessels - the blood must reach bone particulars

We have to find some better information about this. because paste is like filler - no changing into bone accour even partially
the solid structure of HA is little different thing

27F can you show some interesting informatino about this. I need any text where all issues with HA solid implants (not paste) is well explained inluding adventages and disadvantages

The Doctor told me that there is not absorption in the meaning the implant is getting removed from the body, but it's just gonna change into bone... do not how how much true is this...probably he did not tell me all adventages and disadvantages

Plosko: which guy you meant ?

[Lazlo]

show me some frigging pictures. What are you saying RICO? That they have hard HA paste implants? Which ones does this place use? Okay let us know! find pics.

[Rico]

it;s not a paste. it's implant made from hydroxyapatite - you have it in bones... your bone is paste ?  paste is also made from HA but it's not the same...

like cement with water or without - different thing.

i do not also know enough much.
I put the topic and lets try find out what is going on

forget about paste

[Rico]

interesting...but why to remove this ?

for example the surgeons I spoke to, told me they perform this in 2 steps
1) put filler (I forgot which type) into skin, to let the body create additional collagen in this region of skin .at the same time patient and surgeon is able to see how all of this will look like. Making first step they are able to predict the outcome of the second step. If something is not enough right, then it is easy to make some corrections at this step.

2) ... then, after 6-12months the filler is no longer in the skin, and they put this HA implant prepared in 3D modelling (based on the data from  CT for 3D modelling and the first step)

and I was told, this is gonna change into bone forever...
so I try to find out how true is this and how it can be useful for me
I always have to keep in mind that every surgeons team wants to push their method, saying that another is worse etc... you know still marketing and cash... new patients = new researh object

that's all. On the examples it looks quite OK, like it is very good option for mild corrections. but you know ...no surgeon will show you bad results

They claim this procedure is much more safe for the nerves - again true or not.. they always can hit the nerve by nidle

[Rico]

This is not rather the solution i;m gonna choose. but I want to be sure if I should forget about t

since the consultation was short.. and I got permission to ask questions via mails after face-to-face consultation I will ask again what kind of material exactly it is
I need malar bone reposition -whole (osteotomy)  or to put big implant there - on the whole zygomatic bone....whole malar bone - almost from the nose to zygomatic arch and from orbital rim down almost to the teeth.  i's really relatively huge area  I would say 1/5 of the face

Well, I'm gonna to ask the surgeon some questions about this "s**t" please write me what to ask him. That would be helpful.  Please tell me about all issues you know - generally You mentioned some, but all of you can help me little with this. The good thing is I will get feedback which I can share with you

[Rico]

27F you said that previous augumentation made it worse, so you want another one ?

[molestrip]

HA paste doesn't turn into bone. Bone grows into it to keep it in place. Sometimes it can replace it, if the augmentation is small. Since it's porous it becomes vascular, both a good and a bad thing. That means infection is less likely but, on the flip side, it's difficult to impossible to remove. I'd imagine very bloody and what if a nerve grew through it? They'll migrate with the bone underneath and who knows how they resorb. earl25 had some from A/G, one resorbed and one calcified. It's not living tissue so if it breaks it won't heal. All in all, I'd say it's a pretty good product for some things but it's not good as new.

One thing I'm wondering is, we have a technology for growing bone already: BMPs. Why aren't they used here? We can also grow bone in vitro now using the same technology (see epibone.com for example). I don't see any reason why we couldn't etch the bone into the right shape using 3d scans to make a perfect implant. There's a company Dr Schendel founded that does 3d simulations so identifying that implant via simulation should be possible. Someone just needs to put all the pieces together and refine them to make a real product out of it. Were someone sufficiently motivated, I'd expect it could be done in 5-10 years.

That being said, most of us don't need implants or augmentations. They're approximations of what we really need, a larger movement. That's harder to see becoming a reality. Less invasive surgical techniques are needed and more practice by more surgeons.

[Rico]

but surgery means 2 options -  solid implant - like HA (not paste)
or osteotomy ? 

which option are you gonna to choose ?

Can you describe me, why sometimes putting filler before solid implant is good thing ? I know a little from surgeon as I wrote before, but you are longer in this topic...so perhaps you can tell me little more about the issues connected with that

about examples. I saw several. It was OK. Good work. Mostly some patients who wanted to repair his recessed midface. I did not ask about the worst case. Generally I had only 30 minutes ..including 10 minutes during which they examining my and my scans. it's too less

about this mask looking.. you talked about filler or solid implant?  because I won't have filler. the filler is only initial phase of the whole procedure, the main is to put HA which mostly is gonna change into my own bone (I was told that)

in contrast I had already two 1hour consultations with the one surgeon I consider (osteotomy option)
I know from my 1.5year experience ,that one consultation (with the same surgoen) is always not enough,  2 consulattions in most cases is enough

[molestrip]

Purpose of putting filler first is to see if you like it before undergoing something more permanent. I don't like the fillers but then again, I don't like surgery either. The only way I could justify it is to protect the lower eyelid from age related problems and even then, I'd say you could do it with benefit up to late 40s so you probably have some time for technology to improve. Tissue engineering should make great, great strides in the next 1-2 decades.

[Rico]

The only way I could justify it is to protect the lower eyelid from age related problems

Molestrip, what kind of problems you meant ? Tell me more about this lower eyelid issue

[molestrip]

Skin sags as we age and eyelids aren't immune. How quickly it sags is a function of how much support is underneath. People with deficient cheekbones and orbital rims have less support underneath so the eyelid sags more quickly. At first it's mostly aesthetic, as more white shows but it also causes more dryness. Later the eyelids might stop closing or even prolapse. I hear it's easy to fix with surgery but I suspect prevention is better.