Can H.A. Granules provide the same augmentation as implants?

[Lestat]

The fact that hydroxyapatite is "converting" to bone over time, of course has major advantages as there is not a foreign implant present and therefore not the risk of the implant being the cause of problems in the future.

It has been shown that there is a 2 stage response of the body to the placement of the granular version of coralline hydroxyapatite directly on the surface of facial bone. The initial response is the ingrowth of fibrous tissue into the pores in each granule as well as between the granules. After about 2 years the persons bone grows in by a process of osteoconduction to replace the collagen. So the definitive implant is formed by the patients bone.
To place the hydroxyapatite involves surgery on the surface of the bone, to lift the bone’s membrane, and place the granules in the pocket between the bone and the periosteum. It is not injected.

According to one of the best implant surgeons in the states, HA can provide the same augmentation as implants:

"Coral hydroxyapatite if properly placed can produce the same projection as an implant. Implant placement usually requires an operation with more exposure and hence, more swelling than coral hydroxyapatite placement."

- Michael J. Yaremchuk

https://www.realself.com/question/nyc-coral-hydroxyapatite-cheekbone-augmentation

[Bowie]

Interesting and surprising that Yaremchuk said that.

[tim06]

The fact that hydroxyapatite is "converting" to bone over time, of course has major advantages as there is not a foreign implant present and therefore not the risk of the implant being the cause of problems in the future.

It has been shown that there is a 2 stage response of the body to the placement of the granular version of coralline hydroxyapatite directly on the surface of facial bone. The initial response is the ingrowth of fibrous tissue into the pores in each granule as well as between the granules. After about 2 years the persons bone grows in by a process of osteoconduction to replace the collagen. So the definitive implant is formed by the patients bone.
To place the hydroxyapatite involves surgery on the surface of the bone, to lift the bone’s membrane, and place the granules in the pocket between the bone and the periosteum. It is not injected.

According to one of the best implant surgeons in the states, HA can provide the same augmentation as implants:

"Coral hydroxyapatite if properly placed can produce the same projection as an implant. Implant placement usually requires an operation with more exposure and hence, more swelling than coral hydroxyapatite placement."

- Michael J. Yaremchuk

https://www.realself.com/question/nyc-coral-hydroxyapatite-cheekbone-augmentation

Granules are terrible to place, just check what Dr. Eppley says about it. It looks terrible bumpy and uneven and once placed it is really hard and after some time impossible to remove it again. Do you really want a jaw line like in the picture above?

[dervyx]

Granules are terrible to place, just check what Dr. Eppley says about it. It looks terrible bumpy and uneven and once placed it is really hard and after some time impossible to remove it again. Do you really want a jaw line like in the picture above?

It will only look like that if it's placed by inexperienced surgeon who has no idea what's he doing. This is how correctly placed HA granules should look like:

[Lazlo]

YEah that's why Yaremchuk has never used it.

[tim06]

It will only look like that if it's placed by inexperienced surgeon who has no idea what's he doing. This is how correctly placed HA granules should look like:

It is exactly the same bumpy and rough as in the 3d scan, it is just harder to see it in the first pic, which is obviously just a model and not even close to any in vivo application. And in your second pic it basically looks like a bone tumor, would love to see how it looks with the tissue above it. While the concept of such a 'liquid' or formable bone would be brilliant, HA granules isn't like that.

[Lefortitude]

I think in theory it can, but only in certain areas.  granules end up all uneven and asymetrical due to migration in places that experience alot of movement due to facial animation, and places that dont create the tight periostial scar capsule such as the jaw angles. risk goes up when your doing large augmentations.  for paranasal and zygomatic augmentation it works much better.  The granules are super irritating to the soft tissue as it seems to cause a lot of swelling for quite some time.  I think it should be more commonly practiced.  the level of osseointegration described by Bryan Mendelson (sp) in australia is holy grail worthy.

https://www.realself.com/review/melbourne-au-cheek-augmentation-chubby-droopy-face-weak-facial-bones

this is my issue exactly.  face looks chubbyish because of weak bone structure.  a few mm here and there with HA paste would solve my lifes woes.

[Lazlo]

should check out Dr. Kasey Li as he seems to do ZSO

and is a harvard medschool grad and practices in Palo Alto --like basically all the pedigree you'd want in a doc

Li KK. Discussion on "Zygomaticomaxillary Osteotomy for Malar Augmentation". Journal of Oral and Maxillofacial Surgery; 57(1):14-15, 1999.

[Milli_Meters]

should check out Dr. Kasey Li as he seems to do ZSO

and is a harvard medschool grad and practices in Palo Alto --like basically all the pedigree you'd want in a doc

Li KK. Discussion on "Zygomaticomaxillary Osteotomy for Malar Augmentation". Journal of Oral and Maxillofacial Surgery; 57(1):14-15, 1999.

wow. Thanks Lazlo

[Lazlo]

wow. Thanks Lazlo

Let me know if you find anything, I like that he does mandibular widening as well.