Implant Material doesn't Matter?

[IconVillage]

Dr. Eppley states:

What creates an outer facial appearance is the shape of the implant that lies underneath. What composition facial implants are made of makes no difference at all. So that is a misconception.

https://www.eppleyplasticsurgery.com/is-medpor-or-silicone-facial-implants-better/

Is this true? I've been adverse to silicone jaw implants as they look to "puffy," "shiny" and "plastic," but if there is really no difference then is it worth it to pay more for Medpor, PEEK or Titanium if the aesthetic result is dependent on the design and not the material?

Conversely, Dr. Ramirez states:

Medpor gives a sharper and more defined look. It also produces minimal or none bone erosion. Silicone produces significant bone erosion particularly under the pressure of the strong masseter muscle. I will send you a rough draft explaining this and other comparative features

While Dr. van de Ven states:

Another disadvantage of the silicone implant is the unnatural look it mostly gives, if not at the beginning then after a few years when the body of the patient reacts by forming a capsule around the facial implants. The capsule will contract with time and the look becomes more and more unnatural. The unnatural look is the reason why lots of patients have their silicone chin implant removed after a few years. As facial implants, silicone implants are simply not suited.

So what is the truth here?

[kavan]

Oh no. The shape of the implant would have nothing to do with how it looks in your face. Let's see if you can figure out if what I said is true or false.

[IconVillage]

Oh no. The shape of the implant would have nothing to do with how it looks in your face. Let's see if you can figure out if what I said is true or false.

I'm merely asking if the exact same 3D custom design was used in the case of Silicone, Medpor, PEEK and Titanium, would the aesthetic result yield the same outcome? Eppley seems to say yes, while Ramirez believes Medpor provides more angularity.

[kavan]

I'm merely asking if the exact same 3D custom design was used in the case of Silicone, Medpor, PEEK and Titanium, would the aesthetic result yield the same outcome? Eppley seems to say yes, while Ramirez believes Medpor provides more angularity.

More like it that you're demonstrating that you can't think for yourself as to something that should be intuitively obvious and need to be spoon fed.
Have you figured out yet whether my prior statement was true or false?  In the mean time, I'm going to leave it a mystery whether or not Eppley's statement is true or whether or not my statement is true or false.

[ben from UK]

Of course Eppley is going to say 'it makes no difference'. He hasn't been allowed to use materials like peek until recently. Eppley is the typical business scammer. s**tty results for low price. He loves silicone: easy to take out when something goes wrong. And oh boy,  does it go wrong alot of times in his cases.

The shape of the implant plays a role as well. But solicone usually looks a bit more unnatural due to the smoothness of the surface. It also has a tendency to make the screws loose long term due to its softness.

[IconVillage]

Of course Eppley is going to say 'it makes no difference'. He hasn't been allowed to use materials like peek until recently. Eppley is the typical business scammer. s**tty results for low price. He loves silicone: easy to take out when something goes wrong. And oh boy,  does it go wrong alot of times in his cases.

The shape of the implant plays a role as well. But solicone usually looks a bit more unnatural due to the smoothness of the surface. It also has a tendency to make the screws loose long term due to its softness.

Yes, that is what I was thinking, his insistence on silicone seems to be ease of access and his monopolization of the custom implant business in the US which probably allows for some rapport with silicone manufacturers.

However, I think Eppley has some aesthetic eye for producing dramatic, angular results with silicone, but a lot of the time he goes overboard. I have seen some PEEK results with Joel DeFrancq but I didn't notice much of an aesthetic improvement over silicone, or any aesthetic improvement at all. For example, here's a DeFrancq result that didn't produce any angularity and still lends itself to that bloated silicone look:




So far, the best jaw implant results I've seen have come from Dr. Terino (who I believe is retired or extremely old), Dr. Yaremchuk and Dr. Eppley, with the later 2 also having some terrible results and bad reviews as well, but all use silicone.

[kavan]

Of course Eppley is going to say 'it makes no difference'. He hasn't been allowed to use materials like peek until recently. Eppley is the typical business scammer. s**tty results for low price. He loves silicone: easy to take out when something goes wrong. And oh boy,  does it go wrong alot of times in his cases.

The shape of the implant plays a role as well. But solicone usually looks a bit more unnatural due to the smoothness of the surface. It also has a tendency to make the screws loose long term due to its softness.

It doesn't make much to any any difference.  It's the SHAPE of the implant that gives the face shape. When docs talk about which material is better, the reference point is NOT about a custom implant of the SAME shape vs different materials of that same shape.  It's about off shelf ones where they are not all same shape.  Any material can look unnatural if it's the wrong shape for your face.  I'm surprised you didn't get that one.

[kavan]

Yes, that is what I was thinking, his insistence on silicone seems to be ease of access and his monopolization of the custom implant business in the US which probably allows for some rapport with silicone manufacturers.

However, I think Eppley has some aesthetic eye for producing dramatic, angular results with silicone, but a lot of the time he goes overboard. I have seen some PEEK results with Joel DeFrancq but I didn't notice much of an aesthetic improvement over silicone, or any aesthetic improvement at all. For example, here's a DeFrancq result that didn't produce any angularity and still lends itself to that bloated silicone look:




So far, the best jaw implant results I've seen have come from Dr. Terino (who I believe is retired or extremely old), Dr. Yaremchuk and Dr. Eppley, with the later 2 also having some terrible results and bad reviews as well, but all use silicone.

Eppley and sometimes Y get a lot of BLOCK HEADs where the  looks they want  accommodated are extreme. Little to do with the material and more to do with accommodating requests of 'I want what the model has' which doesn't look good on the requester.   It's just easier to put in  piece of squeezable silicone in to accommodate an uncanny valley request from a dummy than doing it with a hard material that can't be folded into the incision.

[ben from UK]

Yes, that is what I was thinking, his insistence on silicone seems to be ease of access and his monopolization of the custom implant business in the US which probably allows for some rapport with silicone manufacturers.

However, I think Eppley has some aesthetic eye for producing dramatic, angular results with silicone, but a lot of the time he goes overboard. I have seen some PEEK results with Joel DeFrancq but I didn't notice much of an aesthetic improvement over silicone, or any aesthetic improvement at all. For example, here's a DeFrancq result that didn't produce any angularity and still lends itself to that bloated silicone look:




So far, the best jaw implant results I've seen have come from Dr. Terino (who I believe is retired or extremely old), Dr. Yaremchuk and Dr. Eppley, with the later 2 also having some terrible results and bad reviews as well, but all use silicone.

This is not bloated silicone look and has nothing to do with the material. This has all to do with the dissappearance of the ogee line. I guarantee you that if you morph the first pic with the same width as the second, you'll get a better result. Why? Because with morphing, you'll only morph the lower part of the jaw and the ogee line is preserved. The ogee line probably dissappeared because of the fact the implant goes up under the masseter muscle, pushing the masseter muscle outwards, making the hollowing of the cheek dissapear. The implant goes up underneath the masseter, and this is often needed to fixate the implant, but it's in many cases problematic cause you only need the implant at the lower boarder of the jaw. That's why some filler results do give the needed angularity, due to the fact they only target the lower part of the jaw. But take a look at almost all implant designs. You see parts that aren't needed aestethically. The ogee line must be preserved, or else you get a bloated look and you lose the subtility in the face. The bigger the implant, the more chances of ruining the ogee line. Unfortunately, the ogee line is very underrated.

[ben from UK]

I morphed the first guy, preserving the ogee line:


But you could question his decision to get an implant in the first place: did he really need an implant?

For some people this procedure is really really a matter of millimeters. One or two millimeters too much or at the wrong places, and you simply go down half a point or sometimes more than one point on the looks scale. Every implant material that isn't needed in one part of the face, should not be there.

[kavan]

The ogee line refers to the CHEEK CURVE from oblique view. It's not a curve that refers to frontal perspective.

[ben from UK]

The ogee line refers to the CHEEK CURVE from oblique view. It's not a curve that refers to frontal perspective.

Then I don't know how to call that area underneath the cheekbones where the shadows of the face are, to the back. This area must not 'pop out' too much. That's the risk of (big) implants.

[kavan]

Then I don't know how to call that area underneath the cheekbones where the shadows of the face are, to the back. This area must not 'pop out' too much. That's the risk of (big) implants.

Area below cheek bone prominence is referred to as 'submalar' or simply; 'below the cheeks'. If it's a matter of wanting to describe an area between the cheeks and jaw bone, it can be referred to in those simple words. Add 'hollow in between' if that's what you mean. It is quite possible to articulate what one is seeing in the absence of (in)correct terminology.

[IconVillage]

Spoke to a max-fac surgeon who uses Titanium implants and he says he prefers them to PEEK as they are more "precise." Interesting.

[LeFort 3000]

titan biggest advantage is having a certain resistance to infection, because infection can mean having to lose the whole implant. titan has proven succesful in other areas of medical surgery