We've been touching on the topic of implants and augmentations in a few posts. I consulted a plastic surgeon yesterday who works with HA and he said he still doesn't use it much simply because the results aren't that great. He said it's not replaced by bone and it sounds great and biocompatible but it's really just as foreign to the body as anything else. He said it was very popular in the 80s. So that's the story on why more surgeons aren't doing that kind of work anymore.
I mentioned once the idea of implants made with real bone. This is possible today really, unfortunately I didn't ask why we aren't seeing it yet. I'd guess it's just a matter of regulatory approval and adaption of the product for this purpose. We already have the software and tooling to customize implants so doing it with real bone shouldn't be much of a challenge. Two products I've seen recently that could work this way are
epibone and
allostem. That's just what I've stumbled upon, I'm sure there's much more here. This is already a very large market but I get the impression facial implants are small beans compared to spinal and trauma work. I think it's only a matter of time before you get essentially a free custom autograft that you could layer where you like. If you don't like it, then you can remove it before the bone grows into it. The need for post-implant moldability is reduced through computer modeling including soft tissue changes. In a osteoconductive product like this, I would think that you could use biodegradable screws but otherwise I don't see why an osteocoductive glue or cement wouldn't work either. It'd be cool to see this stuff used in jaw surgery even, someone just has to pioneer it.