Implant Material doesn't Matter?

[Lefortitude]

Yes total femur replacements are done with titanium. Although they have a very low success rate.

[kavan]

CLUE:

The SAME SHAPE of something can be made from a variety of materials.

If I sculpt something with wax, put it in a cast, melt out the wax and pour in molten bronze, the bronze shape will be SAME as the wax shape I put in there.  I could fill it with Jello too and it would come out the same SHAPE.

The material I use does NOT change the SHAPE of my sculpture. Material comes into play depending what I want to do with the sculpture, give one one away as a gift or eat the other one.

CLUE: A designer dress looks better on a model than does a burlap bag. But the burlap bag is stronger material (or better material). What's more important..the design or the material?

For those still clueless as to how that concept relates to the context of what Eppley is saying, the real question is the one you've gotta ask yourself such as: 'Am I in the capacity to conceptually 'digest' anything a doctor tells me?'

Better check yourself before you wreck yourself.

[ben from UK]

CLUE:

The SAME SHAPE of something can be made from a variety of materials.

If I sculpt something with wax, put it in a cast, melt out the wax and pour in molten bronze, the bronze shape will be SAME as the wax shape I put in there.  I could fill it with Jello too and it would come out the same SHAPE.

The material I use does NOT change the SHAPE of my sculpture. Material comes into play depending what I want to do with the sculpture, give one one away as a gift or eat the other one.

CLUE: A designer dress looks better on a model than does a burlap bag. But the burlap bag is stronger material (or better material). What's more important..the design or the material?

For those still clueless as to how that concept relates to the context of what Eppley is saying, the real question is the one you've gotta ask yourself such as: 'Am I in the capacity to conceptually 'digest' anything a doctor tells me?'

Better check yourself before you wreck yourself.

Shape is one thing. Other things do play a role as well. The roughness of the surface versus smoothness for example. Peek is rougher than silicone. Skin sticks less on silicone because of this. If a material is porous or not plays a role as well. Porous implants allow for tissue ingrowth.

I had both silicone and Peek and I think Peek looks more natural. I do agree that the shape of the implant plays the most important role. It also depends on someone's face. Some faces can take up silicone, others nit so much.

[kavan]

Shape is one thing. Other things do play a role as well. The roughness of the surface versus smoothness for example. Peek is rougher than silicone. Skin sticks less on silicone because of this. If a material is porous or not plays a role as well. Porous implants allow for tissue ingrowth.

I had both silicone and Peek and I think Peek looks more natural. I do agree that the shape of the implant plays the most important role. It also depends on someone's face. Some faces can take up silicone, others nit so much.

Well, ya that's a point here. But the other point is that material is a secondary consideration. For example for all materials that make the SAME SHAPE, are you so sure the design is going to be what you want to see in the mirror that you wouldn't want it removed, then you can choose something with tissue ingrowth over silicone OR if you don't mind a LARGER incision to place a titanium implant (which can't be folded and placed through a smaller one like silicone), then choose titanium.   This refers to CUSTOM implants of SAME SHAPE.

By the way, skin does not 'stick' to ANY implant, silicone or other. Implants are placed to subperiosteal plane which is well below any direct contact with the skin.

[ben from UK]

Well, ya that's a point here. But the other point is that material is a secondary consideration. For example for all materials that make the SAME SHAPE, are you so sure the design is going to be what you want to see in the mirror that you wouldn't want it removed, then you can choose something with tissue ingrowth over silicone OR if you don't mind a LARGER incision to place a titanium implant (which can't be folded and placed through a smaller one like silicone), then choose titanium.   This refers to CUSTOM implants of SAME SHAPE.

By the way, skin does not 'stick' to ANY implant, silicone or other. Implants are placed to subperiosteal plane which is well below any direct contact with the skin.

Yeah you're right. I meant the tissue.

But yeah, shape is most important. If the shape is too big or doesn't fit the underlying bone structure, one might get unnatural looking results.

[tim06]

Well, ya that's a point here. But the other point is that material is a secondary consideration. For example for all materials that make the SAME SHAPE, are you so sure the design is going to be what you want to see in the mirror that you wouldn't want it removed, then you can choose something with tissue ingrowth over silicone OR if you don't mind a LARGER incision to place a titanium implant (which can't be folded and placed through a smaller one like silicone), then choose titanium.   This refers to CUSTOM implants of SAME SHAPE.

By the way, skin does not 'stick' to ANY implant, silicone or other. Implants are placed to subperiosteal plane which is well below any direct contact with the skin.

What do you think of this result: https://imgur.com/a/bjkdr

You can find more context here: https://www.reddit.com/r/PlasticSurgery/comments/7z5u5m/i_got_silicone_chin_and_jaw_implants_2_weeks_post/

Personally I think it looks great, but with implants I would always fear that they can get infected or even show trough the flesh which isn't uncommon.

To put the price point of $10k into perspective, for that kind of money you can either get a small used car or a surgery which changes your social, professional and love life forever.

[kavan]

What do you think of this result: https://imgur.com/a/bjkdr

You can find more context here: https://www.reddit.com/r/PlasticSurgery/comments/7z5u5m/i_got_silicone_chin_and_jaw_implants_2_weeks_post/

Personally I think it looks great, but with implants I would always fear that they can get infected or even show trough the flesh which isn't uncommon.

To put the price point of $10k into perspective, for that kind of money you can either get a small used car or a surgery which changes your social, professional and love life forever.

ehhh...it's ok and clearly the guy is happy with it. So, his liking it is going to be more important than my opinion on it is. Also, keep in mind you're asking someone, me, who can spot stuff that the average onlooker won't be looking for.

That said, to my eye, his class 2 skeletal pattern of recessive jaw, in particular, his lower lip being BEHIND his upper lip, is still visible despite his trying to compensate for jaw recession which is done by making his chin more prominent in both projection and length. Although the jaw implant aspect of it can augment laterally and down to beef up the back part, the one direction no jaw implant can reproduce is bringing the mandible forward (lips go with that when BSSO brings mandible forward). Hence the OVER COMPENSATION to the chin.

Again, I see things others don't and what I see is jaw recession masked by the over compensation to the chin. But I realize that's what they GOTTA do when people want to hide the jaw recession that way.

[ben from UK]

What do you think of this result: https://imgur.com/a/bjkdr

You can find more context here: https://www.reddit.com/r/PlasticSurgery/comments/7z5u5m/i_got_silicone_chin_and_jaw_implants_2_weeks_post/

Personally I think it looks great, but with implants I would always fear that they can get infected or even show trough the flesh which isn't uncommon.

To put the price point of $10k into perspective, for that kind of money you can either get a small used car or a surgery which changes your social, professional and love life forever.

Yeah like Kavan said, chin looks a little bit too much but it's much better than before. I personally would have made it a little less long, but some American surgeons like it big. He had very recessed chin.

He has other flaws like philtrum, but the facial structure is better than before. Infection of chin implant is highly unlikely, especially when it's done through the exterior.

[Post bimax]

ehhh...it's ok and clearly the guy is happy with it. So, his liking it is going to be more important than my opinion on it is. Also, keep in mind you're asking someone, me, who can spot stuff that the average onlooker won't be looking for.

That said, to my eye, his class 2 skeletal pattern of recessive jaw, in particular, his lower lip being BEHIND his upper lip, is still visible despite his trying to compensate for jaw recession which is done by making his chin more prominent in both projection and length. Although the jaw implant aspect of it can augment laterally and down to beef up the back part, the one direction no jaw implant can reproduce is bringing the mandible forward (lips go with that when BSSO brings mandible forward). Hence the OVER COMPENSATION to the chin.

Again, I see things others don't and what I see is jaw recession masked by the over compensation to the chin. But I realize that's what they GOTTA do when people want to hide the jaw recession that way.

How should the lips ideally be positioned? My lower lip was in front of my upper pre-op but now my upper is several MMs more forward than my lower post-op.

[kavan]

How should the lips ideally be positioned? My lower lip was in front of my upper pre-op but now my upper is several MMs more forward than my lower post-op.

I gotta make this short as verbally describing 'ideals' takes a lot of time ....Not the way the guy's are in that photo where his lower lip is that much behind.  In general the lips should look like they line up.

[Post bimax]

I gotta make this short as verbally describing 'ideals' takes a lot of time ....Not the way the guy's are in that photo where his lower lip is that much behind.  In general the lips should look like they line up.

Yeah I mainly just meant ‘ideal’ relationship with respect to the A-P plane, thank you. My upper lip vermillion projects a few MMS anteriorly more than my lower, which is the opposite of my pre-op. I’m guessing this is due to the somewhat clockwise movement which was compensated with a genioplasty. That seems to put me in a similar position as the guy in the photo which is why I asked.

[kavan]

Yeah I mainly just meant ‘ideal’ relationship with respect to the A-P plane, thank you. My upper lip vermillion projects a few MMS anteriorly more than my lower, which is the opposite of my pre-op. I’m guessing this is due to the somewhat clockwise movement which was compensated with a genioplasty. That seems to put me in a similar position as the guy in the photo which is why I asked.

Thing is, my response was in reference to being asked about someone's implants and photos of which where the question was within the scope of the general topic of the thread; SHAPE of IMPLANTS. Something where my observations were within the context of applying to the topic matter at hand.

Your question not only required a SHIFT in SCOPE to address but also for me to draft up a doctrine in 'ideal' lip relationships as to be directly applicable to your own specifics, (which have nothing to do with the shape of implants) whereas I KNOW I've ALREADY targeted focus on your lip situation. It has nothing to do with 'lip line up'  but rather contour irregularity to the labial ledge.

[Post bimax]

Thing is, my response was in reference to being asked about someone's implants and photos of which where the question was within the scope of the general topic of the thread; SHAPE of IMPLANTS. Something where my observations were within the context of applying to the topic matter at hand.

Your question not only required a SHIFT in SCOPE to address but also for me to draft up a doctrine in 'ideal' lip relationships as to be directly applicable to your own specifics, (which have nothing to do with the shape of implants) whereas I KNOW I've ALREADY targeted focus on your lip situation. It has nothing to do with 'lip line up'  but rather contour irregularity to the labial ledge.

Yeah, I was curious about the A-P relationship between the upper and lower lip because in a prior post you said the subject’s lip orientation is indicative of a class 2 skeletal pattern. I identified a similar A-P lip relationship in my own case and also believe my lower jaw is a bit (relatively) recessed, so I was postulating about whether it is also indicative of a class 2 pattern in my case. That’s a different question than the convexity or convexity of the upper lip itself.

I asked about the ideal because I was trying to figure out what the upper-lower A-P relationship ‘should’ be. I.e, what lip orientation would indicate a balanced skeletal pattern. I’m satisfied with the above answer though.

[kavan]

Yeah, I was curious about the A-P relationship between the upper and lower lip because in a prior post you said the subject’s lip orientation is indicative of a class 2 skeletal pattern. I identified a similar A-P lip relationship in my own case and also believe my lower jaw is a bit (relatively) recessed, so I was postulating about whether it is also indicative of a class 2 pattern in my case. That’s a different question than the convexity or convexity of the upper lip itself.

I asked about the ideal because I was trying to figure out what the upper-lower A-P relationship ‘should’ be. I.e, what lip orientation would indicate a balanced skeletal pattern. I’m satisfied with the above answer though.

Yes, I said his lip orientation was indicative of class 2 skeletal pattern. BUT the key reference was to his actual before photo where it's ALSO quite obvious he had recession to mandible which was consistent with type 2 skeletal pattern. I established consistency with his lip line up and jaw recession.

So, despite his having the implants to mask the jaw recession, the lip line up remained as prior. That is to say, it was a residual tell tale sign to his skeletal pattern which belied the implants didn't hide it completely.

Unless your before photos reveal your lower jaw was as recessive as his (relative to his upper jaw) and ALSO your lower lip was BEHIND your upper lip (but you say your lip posture was OPPOSITE of his), and also IF my statement contended that lip posture ALONE in absence of seeing jaw posture WITH it was key identifier (which I didn't), there's nothing about the context of my statements  for you to self identify with here or for me to 'define' ideal lip posture in A-P because you did just because I ID'd a residual tell tale sign of a posture consistent with another person's highly recessive lower jaw subsequent to his before photo showing BOTH.

[Post bimax]

Yes, I said his lip orientation was indicative of class 2 skeletal pattern. BUT the key reference was to his actual before photo where it's ALSO quite obvious he had recession to mandible which was consistent with type 2 skeletal pattern. I established consistency with his lip line up and jaw recession.

So, despite his having the implants to mask the jaw recession, the lip line up remained as prior. That is to say, it was a residual tell tale sign to his skeletal pattern which belied the implants didn't hide it completely.

Unless your before photos reveal your lower jaw was as recessive as his (relative to his upper jaw) and ALSO your lower lip was BEHIND your upper lip (but you say your lip posture was OPPOSITE of his), and also IF my statement contended that lip posture ALONE in absence of seeing jaw posture WITH it was key identifier (which I didn't), there's nothing about the context of my statements  for you to self identify with here or for me to 'define' ideal lip posture in A-P because you did just because I ID'd a residual tell tale sign of a posture consistent with another person's highly recessive lower jaw subsequent to his before photo showing BOTH.

My thinking was that I may have been moved into a ‘more’ class 2 position by the operation and that the upper-lower lip A-P relationship differential pre and post op is a reflection of that.

I’m not claiming you ever said the A-P relationship in isolation is a “key indicator” of class 2. Only that there may in fact be some correlation. I’m not trying to draw any hard conclusions about the significance of lip orientation. Just trying to learn more and think about it.