Has anyone had a surgery with Dr Bryan Mendelson ?

[Melalb]

Hi,
I am a female and I am new here. I am currently undergoing an orthodontic treatment for my overbite which will be followed by a lower jaw surgery and sliding genioplasty. As this will hopefully fix my recessed small jaw and give me a chin it will mostly likely do nothing for my week maxilla and underdeveloped cheekbones. ( My facial width is okay I need more forward projection) I have consulted with a few surgeons and at this stage I am deciding between augmentation with HA granules with Bryan Mendelson or custom made implants ( have not settled on the surgeon as yet). If I was to do a surgery with Mendelson I would also get him to augment my eyebrows which are quite flat and sagging laterally. Has anyone had any experience with him ? He seems to know what he is doing with HA and the before/after pictures I saw were quite impressive ( even his practice manager I spoke to had her cheekbones augmented with HA)  however I have also come across a few negative review which are quite worrying.If anyone can provide any feedback it would be much appreciated.
Thank you

[PloskoPlus]

I've seen his results. I didn't find them impressive. Most of the effect was from the swelling and the cheek lift. The actual augmentation is very imprecise and small. Just look at the x rays - it's a small rough ball. HA is an irritant. It causes prolonged swelling (rough texture). It's also a one way trip - it cannot be removed and neither more ha, nor implants can be put over it later. He also charges an absolute fortune for it. For that $ you can have jaw surgery with a world class jaw surgeon, rather than one of our local glorified dentists.

[Melalb]

Thank you for your reply. I will be having the jaw surgery with a maxillofacial surgeon in Melbourne. He is based at OMFS has good credentials and I feel comfortable with him. I have briefly talked to him about facial implants however he doesn't seem to like them and would not do it together with the jaw surgery due to possible infection. Hence I am looking into a secondary procedure to fix my cheeks. I understand that the augmentation with HA is subtle but I think I could be okay with it if its done well in addition I also need the cheek lift as my cheek tissue has already dropped due to the lack of bony support. Can you please explain why a custom made implant cannot be put over it later if necessary ? He told me that it can be removed if necessary (infection) however its not an easy job..Do you have any experience with custom made cheeks implants ??

[PloskoPlus]

Thank you for your reply. I will be having the jaw surgery with a maxillofacial surgeon in Melbourne. He is based at OMFS has good credentials and I feel comfortable with him. I have briefly talked to him about facial implants however he doesn't seem to like them and would not do it together with the jaw surgery due to possible infection. Hence I am looking into a secondary procedure to fix my cheeks. I understand that the augmentation with HA is subtle but I think I could be okay with it if its done well in addition I also need the cheek lift as my cheek tissue has already dropped due to the lack of bony support. Can you please explain why a custom made implant cannot be put over it later if necessary ? He told me that it can be removed if necessary (infection) however its not an easy job..Do you have any experience with custom made cheeks implants ??

Did your jaw surgeon say "muscle likes to be next to bone"?  I don't remember the exact reason why nothing can be placed over the HA, but considering the rough appearance of HA augmentation, I don't think that's surprising.  BTW, HA can also get infected like pretty much every other foreign body and no it does not magically "get replaced with your own bone over time".  Consult with Patrishia Bordbar.  She does zygomatic osteotomies besides jaw surgery.  In some cases they seem to do nothing, in other cases they produce some noticeable positive change - "your mileage may vary".  Also consider seeing a top oculoplastic surgeon like Taban.  The upper mid face/eye area is too sensitive to be left to hacks.

[Melalb]

Thank you for your advice. Spoke to Bordbar's PA and she doesn't do zygomatic osteotomies for cosmetic reasons only functional. She would only do the lower jaw surgery and genioplasty for me not the cheeks though. Had a Skype consultation with Taban a while ago he suggested a silicon cheek implant in conjunction with a cheek lift which I see as a last resort solution. I understand that HA is just another onlay implant and is also carries risks as any other implant however my understanding is that the infection rate are much lower compared to medpor, silicon, peek ? Also contacted Dr Zarrinbal's PA in regards to zygomatic osteotomies she should get back to me with some answers in a couple of days.

[Lazlo]

Thank you for your advice. Spoke to Bordbar's PA and she doesn't do zygomatic osteotomies for cosmetic reasons only functional. She would only do the lower jaw surgery and genioplasty for me not the cheeks though. Had a Skype consultation with Taban a while ago he suggested a silicon cheek implant in conjunction with a cheek lift which I see as a last resort solution. I understand that HA is just another onlay implant and is also carries risks as any other implant however my understanding is that the infection rate are much lower compared to medpor, silicon, peek ? Also contacted Dr Zarrinbal's PA in regards to zygomatic osteotomies she should get back to me with some answers in a couple of days.

Try Dr. Anthony Wolfe --he does full malar osteotomies. Find out what it is and report back cause I think his procedure might be really good.

http://santhonywolfemd.com/

[Melalb]

Try Dr. Anthony Wolfe --he does full malar osteotomies. Find out what it is and report back cause I think his procedure might be really good.

http://santhonywolfemd.com/

Thx. I will try to contact him although I would much prefer to find someone who does zygomatic osteotomies either in Australia or Europe. Any recommendations besides Dr. Zarrinbal ?

[Notctr]

Hey,

I didn't have surgery with him but I did have surgery with an apprentice of him.
The result is very natural and subtle. I suppose that with an implant you can achieve a more prominent result, but I wanted my result to be natural so that it would age gracefully with me and I don't think that's the case with artificial implants.

In my surgery the hydroxyapatitewas applied from each side inside my nose, so no visible scars whatsoever, and I had a fat transfer over it. if I touch it with my finger it feels like bone.
It has very little chance to get infected, and unlike implants, I don't think you would want to have them removed since the result is very subtle. The only downside is that unless you are a doing a facelift, it can't be applied in the submalar bone and I was hoping to achieve some volume there.

Anyway, someone mentioned that in x rays it looks rough? I'm really curious to see that.

[PloskoPlus]

Anyway, someone mentioned that in x rays it looks rough? I'm really curious to see that.

https://bmendelson.com.au/wp-content/themes/BM/pdf/(2010)%20Fate%20of%20hydroxyapatite.pdf

[GJ]

https://bmendelson.com.au/wp-content/themes/BM/pdf/(2010)%20Fate%20of%20hydroxyapatite.pdf

Kinda fishy they used 2 years for the study and then concluded that because it's good at 2 years it's good for life. Bad methodology and bad deduction.
Mendelson also is known for promoting HA.

I think the stuff A/G use is a bit different in that it's mixed with other material (plasma or something? I forget), so I'm not sure if this article applies to all HA, either.

[kavan]

Kinda fishy they used 2 years for the study and then concluded that because it's good at 2 years it's good for life. Bad methodology and bad deduction.
Mendelson also is known for promoting HA.

I think the stuff A/G use is a bit different in that it's mixed with other material (plasma or something? I forget), so I'm not sure if this article applies to all HA, either.

The GRANULES  are more suited for HA augmentation than HA 'paste'. Neither Gunson nor Mendelson use HA 'paste'. They both use the granules.  The paste is good for filling in dents and dingies but hard to get right as an onlay. So, the article does not apply to all HA. But it does apply to the SAME stuff that Gunson also uses.

[PloskoPlus]

The GRANULES  are more suited for HA augmentation than HA 'paste'. Neither Gunson nor Mendelson use HA 'paste'. They both use the granules.  The paste is good for filling in dents and dingies but hard to get right as an onlay. So, the article does not apply to all HA. But it does apply to the SAME stuff that Gunson also uses.

Yes, Gunson and Mendelson use the same stuff.  One local PS said "BM is a great surgeon (standard disclaimer surgeons like to use before saying such and such is full of s**t), but such a big surgery with so much swelling for minimal result and that HA he uses is old school".

[kavan]

Yes, Gunson and Mendelson use the same stuff.  One local PS said "BM is a great surgeon (standard disclaimer surgeons like to use before saying such and such is full of s**t), but such a big surgery with so much swelling for minimal result and that HA he uses is old school".

and...they both use it for very MODEST augmentations (small) which is good if the person needs only a modest enhancement. I realize that some people need MORE augmentation than the HA granules are capable of. But I have no idea what extent of advancement the OP needs. If it's a small to modest one, then she's probably a good match for what he does.

[Notctr]

I'm so tempted to post my before and after pictures, I just don't want everyone seeing my face haha.

I had a really flat face to begin with, after the surgery nobody that saw me for the first time could tell I had anything done to my face, but I've been told I have prominent cheekbones and an angular face.

You definitely won't get as much projection as with an implant, but I chose what I thought was the safest and most natural alternative, and I'm happy I did, I'm very happy with the results even after 2 years past the surgery.

[Lestat]

BTW, HA can also get infected like pretty much every other foreign body and no it does not magically "get replaced with your own bone over time".  Consult with Patrishia Bordbar.

 

HA is very natural and it is very unlikely that it will ever become infected. The nice thing about the HA versus a silicone implant is that vessels actually can grow throughout the material and if for some reason it were to get infected, it can be effectively treated with oral antibiotics.