If you get HA paste augmentation a la Arnett & Gunson, does that make it impossible (or at least inadvisable) to later put medpor implants over the same areas?
I'm not absolutely sure. The way a medpore implant works is it has these little tiny holes all through it where I THINK the the bone tissue and the scar tissue grow into it. (OK, I absolutely know the scar tissue grows into the holes.) I think that is so (bone tissue growing into the holes) because I've heard of situations where a patient has the medpore implants to the jaw, gets an X ray for the dentist and the dentist does not see the presence of the implant. But they can detect the presence of a silicone one. So, that's why I THINK--and am kind of sure--bone tissue also grows into the holes from where it's making direct contact with the bone.
I also know of a few patients who first had the HA granules to the jaw (Gunson uses those) and had to get them SCRAPED OFF the bone before the jaw implant doctor would put a medpore implant to correct what the granules didn't.
Although I'm not 'absolutely sure', I'm inclined to think that the medpore implant needs absolute CONTACT with the bone with nothing else on the bone, like HA. When they screw down a medpore implant to your facial skull it's so it does not move around in the initial healing stages. But once it establishes itself, it's really FIXED in there like it's really PART of your own bone which is why they are problematic to remove and hard to detect on an X ray.
With a silicone implant, I've seen cases where they can be overlayed TO a medpore (formally known as 'porex'). But NOT the other way around.
The body forms a scar capsule around the silicone implant (assuming it's a smooth one). No tissue ingrowth which is what it makes it easier to remove.
So, I'm inclined to think you could get a silicone implant over prior HA but not medpore over the HA.
