dr. yaremchuk

[earl25]

any one use him for orbital rims?

[pekay]

a few people in here had their orbital rims augmented with HA back when they had jaw surgery with A&G

[earl25]

I had a dr. who wanted to augment mine with HA. I don't have a good feeling about it. I need lik 5mm of augmentation. that's a lot to ask from a paste imo. I feel I need a hard implant

[falcao]

I'm having these at the same time with my orthognathic surgery in September - not with Yaremchuk of course, although I did consult him. So, I can't tell you yet what the result is, but I have high hopes, as the implant will be custom-made for me to perfectly fit. I agree with you - HA will not give good results there, and I was also told it's not very stable in that area. I also need around 5mm.

[falcao]

No, I don't know this for a fact. But I'm 100% sure that I want implants there and not HA. I, like the OP, am convinced that you can't have that level of augmentation (5mm or more) with HA. At best you can hope for a very subtle result, at worst it will do nothing. Not to mention the fact that it is not entirely stable up there. Implants are much, much lower risk and potentially can give you a 10 times better result, especially if they are customized for you, and not the off-the-shelf type.

[falcao]

Yes, it's true. It can be even visible with a naked eye (at least to you), although I doubt that many people will notice anything at all. I guess that's the risk. The risk of shifting is really minimal with the new types that have a good grip on the bone. You have a big choice of these - medpor, gore-tex, or even silicone ones coated in material that provides for a good grip. Most surgeons nowadays will also screw them in their place. Of course, harder to remove if things go wrong, but you have to take calculated risks with these things or you'll never achieve anything. I will let you know in Sept/Oct if everything goes well. 

[pekay]

No, I don't know this for a fact. But I'm 100% sure that I want implants there and not HA. I, like the OP, am convinced that you can't have that level of augmentation (5mm or more) with HA.

I don't remember where exactly but I read that HA augmentation can only provide 4-5mm of projection and like falcao said that usually isn't enough to correct a deficiency

All implants must be secured in place with a titanium screw to avoid shifting

[pekay]

another problem with HA is that it basically comes down to guess-timation whereas implants are custom fitted/shaved to suit you

from Dr Eppley's site

NSFW i guess?

[falcao]

pakay - 4-5mm is not insignificant for cosmetic reasons, for most faces it would be perfect, but I seriously doubt that HA can give you that much. Now, if you're really deficient there - accident, genetic/birth defects, they offer these in much larger sizes - 7mm for example. Have a look at the medpor catalog - scroll down towards the middle, p.12, 13...and have a look at the shapes and sizes available. That being said, CUSTOM ones that they will manufacture based on a model of your own skull are always much better although more expensive.

http://www.askin.co.at/askin/images/stories/Porex/2010facialcontoursbrochure.pdf

There is a much better/more detailed catalog than this one, if I find it, I'll post a link

[falcao]

Well noted. He may be the surgeon with the largest internet presence in the world - he's all over. I've heard mixed opinions on him, from very critical to very positive. What I do know about him, is that he works really hard. I've written him a couple of times, asking difficult questions, and each time he answered personally (rather than a receptionist offering me an appointment for $250). He took the time to understand my complicated questions, analyze the pictures I've attached and each time gave me a good answer that I was satisfied with and was helpful to me for doing further research. I appreciate that, as very, very few surgeons respond personally nowadays and even fewer will offer any advice completely free of charge. So my advice - always worth sending him an email. He may give you some valuable insights.

[Kristen]

I checked out a little of Eppley's website and I really like a lot of the results.
I see some people who would definately would be jaw surgery candidates who aesthetically got more facial balance from some of his procedures.   I like his rhinoplasties too.