Definitive Guide to Facial Implants: Reality Edition 2019

[Reality]

PREFACE

I've read so many medical journals and peer reviewed articles regarding facial implants, that overall, it's starting to feel cryptic and I'm becoming vexed. What's more, is that in- context of real world application concerning viability: Bio-compatibility & long-term stability of facial implants; most of the aforementioned become null & void (i.e. statistics & numbers don't exactly translate into reality: viable outcomes)

Furthermore, my healing is complete and soon I will have to make a decision as to which implant material to utilize for my mandible and jaw angles. Previous to this, I had seriously considered a CW to increase my bigonial distance (posterior width of the lower jaw) but it seems impractical and quixotic (for my case). I am still considering total Orthognathic surgery, depending on the practitioner. However, I've currently been receiving plenty of mixed feedback from different surgeons (i.e. I would be a good candidate for jaw surgery or it isn't necessary etc...). So, at this stage I am still researching and committed to consultations. Moreover, I'm not sure I wish to invest my time with such a lengthy expedition, as I already know that I can "get away" with implants. The key is, what type of implants and who has the experience to perform with exact prowess.

With that said, many of you have messaged me sharing similar concerns and/or situations, akin to myself and are also looking for information/answers. That's great and you can still do so but I think it even better if we can all openly discuss this topic on the forum.   

The aims of this thread are to:
• Provide a summation of real-world firsthand accounts, from those who've had or currently have; experience with facial implants.
• Discuss those surgeons who utilize implantation, as well as the materials & methodologies of which they employ.

Simply stated, this topic should not be opaque and my hope is that we can all add to the transparency, in order to make the most appropriate decision with respect to our situations.


 Ｒｅａｌｉｔｙ


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R͚e͚a͚l͚i͚t͚y͚ Rͦͯͦͯeͦͯͦͯaͦͯͦͯlͦͯͦͯiͦͯͦͯtͦͯͦͯyͦͯͦͯ

[Austinou88]

Personally, I don't really know that much about implants, but I glanced at something
called CT-Bone. I'm curious to your thoughts on this?

It says: "CT-Bone® is a bone-like customized implant that can be 3D
printed and is converted to real bone by the patient."

Website: https://www.xilloc.com/ct-bone/

[tim06]

Below you can find an about 100 page long presentation of a Belgian specialist who works with titanium to create custom jaw implants. It is the most in-depth report on the topic I have ever seen with detailed pictures on the procedure and before/after pics.

I did a lot of research myself and can really recommend you to take the time to check it out:

https://ufile.io/1eg2i
(It will take some time to load since it is a 50mb .PDF)

[ben from UK]

Titanium and peek are the best implant material. Another thing is that it's impossible for any surgeon to precisely predict the outcome of implants and thus create the right size based on a skull model. There's alot of guessing which makes it a tricky procedure.

[djsbelgium]

Below you can find an about 100 page long presentation of a Belgian specialist who works with titanium to create custom jaw implants. It is the most in-depth report on the topic I have ever seen with detailed pictures on the procedure and before/after pics.

I did a lot of research myself and can really recommend you to take the time to check it out:

https://ufile.io/1eg2i
(It will take some time to load since it is a 50mb .PDF)

File's been deleted

[tim06]

Does anyone here plan to get an implant in 2019?

What material will you use?

Is it custom created?

[Reality]

I apologize as I've neglected this thread: it was supposed to be a comprehensive write up of each implant material, however I've been busy with projects & other endeavors. Eventually, I will have a write up for those interested.

@Tim06 The plan is to combine an osteotomy (genio), with a wraparound implant made from PEEK.

[fulcanelli]

Definitely interested to hear more. Especially why you have chosen peek over titanium? Also who are the surgeons to go to?

[dardok]

The ideal implant should be free of long term complications being infection and erosion/resorption.
Otherwise how is it a better alternative to osteotomies.

My knowledge on implant materials is relatively little but it seems almost every implant carries some sort of complication risk long term.

If there are any that do not I would imagine these would be the best material.

[ben from UK]

The ideal implant should be free of long term complications being infection and erosion/resorption.
Otherwise how is it a better alternative to osteotomies.

My knowledge on implant materials is relatively little but it seems almost every implant carries some sort of complication risk long term.

If there are any that do not I would imagine these would be the best material.

There is no implant material that is free of potential infection. There is also no osteotomy that is free of potential infection. Remember that with osteotomies, surgeons use foreign material as well (screws, plates etc.). Even without plates and screws, you can get an infection with osteotomies, which can cause absorption of the bonegraft if a bonegraft is used.

Complication risk with implants is highest in short term (infection). Between 6 and 12 weeks is when most infections happen.

Every surgery on the face has high risk potential: dissatisfaction with results, infection, asymmetry, unnatural results, numbness, erosion, etc. To get out of a surgery completely satisfied, with no complications, the chances are low. Osteotomies are risky as well. Lots of cases with asymmetry, longfaces, blunted jawangles, etc.

The industry is pretty much in an error & trial phase and most patients follow hypes they read on the net. So if someone say fillers are great, they fly to brasil to get dangerous permanent fillers. Someone else posts good results from chinwing, and they all think chin wing is the miracle cure. And that's how it goes.

 

[Lestat]

Infections with osteotomies are rare compared to implants and can in most cases be treated with antibiotics. if not, the infected screws and plates can always be removed even in local anesthetic (at least six months after surgery), which does not affect the aesthetic result.

[ben from UK]

Infections with osteotomies are rare compared to implants and can in most cases be treated with antibiotics. if not, the infected screws and plates can always be removed even in local anesthetic (at least six months after surgery), which does not affect the aesthetic result.

True,

The risdon approach (external) would lower the risk of infection of jawimplants, just like an external approach of a chin implant reduces the risk of infection. But I don't know how visible that scar would be. It doesn't look very aestethic to walk around with a visible scar. A scar under the chin is not very visible.

I think most infections occur due to a bad bacteria entering the site during surgery. Not much you can do about it except cleaning the whole mouth a couple of months prior to the surgery by your dentist. Surgeons always say that the risk of infection is very low, and they state percentages of 2 or 3%, some of them say they never had a client with an infection. It seems very unlikely, unless they almost never perform this procedure. The risk is appr. 15% one surgeon told me, but maybe he wasn't telling the truth as well and the real number is higher. I personally don't believe the percentages stated in research. Some research articles are written by plastic surgeons themselves. They aren't objective. It also depends on the timeframe.

[PloskoPlus]

True,

The risdon approach (external) would lower the risk of infection of jawimplants, just like an external approach of a chin implant reduces the risk of infection. But I don't know how visible that scar would be. It doesn't look very aestethic to walk around with a visible scar. A scar under the chin is not very visible.

I think most infections occur due to a bad bacteria entering the site during surgery. Not much you can do about it except cleaning the whole mouth a couple of months prior to the surgery by your dentist. Surgeons always say that the risk of infection is very low, and they state percentages of 2 or 3%, some of them say they never had a client with an infection. It seems very unlikely, unless they almost never perform this procedure. The risk is appr. 15% one surgeon told me, but maybe he wasn't telling the truth as well and the real number is higher. I personally don't believe the percentages stated in research. Some research articles are written by plastic surgeons themselves. They aren't objective. It also depends on the timeframe.

Same with nerve damage from orthognathic surgery.  Surgeons always lie and downplay the risks, and say "permanent numbness is rare".  Yet almost everybody has at least some numbness, even if it's a small patch.

[ben from UK]

The problem is every seller of a product downgrades the negative. The chances are higher to sell your product if you downgrade risks. If surgeon A says: the risk of infection with jawimplants is 15% and surgeon B says 2%, surgeon B has more chance to sell the procedure. They are forced to lie due to the system. The buyer/consumer is dumb and easily manipulated, especially when it comes to eastethic procedures, cause alot of clients are desperate. They also want to hear positive things, so they are fed with positive stories, they are showed the best results, etc.

That's why you see fake percentages on Realself for example. It's a selling game. Maybe the risk of chin implant is very low, but you can't use that percentage on jaw angle implants or wrap around implants, and I guess many surgeons just switch the numbers. In most countries, the rules aren't very strict, but usually you are not allowed to misinform clients. They use a consent form but there are many ways to inform clients/communicate. You can choose your words carefully, you can hide information, etc. That's how businesses work. There is no real control anyway, no real percentages on the net, lots of misinformation. It's a mess.

[PloskoPlus]

The problem is every seller of a product downgrades the negative. The chances are higher to sell your product if you downgrade risks. If surgeon A says: the risk of infection with jawimplants is 15% and surgeon B says 2%, surgeon B has more chance to sell the procedure. They are forced to lie due to the system. The buyer/consumer is dumb and easily manipulated, especially when it comes to eastethic procedures, cause alot of clients are desperate. They also want to hear positive things, so they are fed with positive stories, they are showed the best results, etc.

That's why you see fake percentages on Realself for example. It's a selling game. Maybe the risk of chin implant is very low, but you can't use that percentage on jaw angle implants or wrap around implants, and I guess many surgeons just switch the numbers. In most countries, the rules aren't very strict, but usually you are not allowed to misinform clients. They use a consent form but there are many ways to inform clients/communicate. You can choose your words carefully, you can hide information, etc. That's how businesses work. There is no real control anyway, no real percentages on the net, lots of misinformation. It's a mess.

Unfortunately, surgeons are a law unto themselves.