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General Category => Functional Surgery Questions => Topic started by: Optimistic on December 13, 2013, 03:09:41 AM

Title: Hydroxyapatite binds to skin?
Post by: Optimistic on December 13, 2013, 03:09:41 AM
I've read some people state that HA when applied to bone will also somehow attach itself to the flesh/skin/whatever it's called, and that this can have a positive effect on ageing as it would prevent sagging. Can anyone confirm if there's any merit to this? It's certainly not something I've ever read before in a study, nor have I seen it discussed before outside of this particular thread on a jaw surgery forum (doctors were also posting and no correction was made).

Title: Re: Hydroxyapatite binds to skin?
Post by: Lazlo on December 13, 2013, 08:00:04 AM
I've read some people state that HA when applied to bone will also somehow attach itself to the flesh/skin/whatever it's called, and that this can have a positive effect on ageing as it would prevent sagging. Can anyone confirm if there's any merit to this? It's certainly not something I've ever read before in a study, nor have I seen it discussed before outside of this particular thread on a jaw surgery forum (doctors were also posting and no correction was made).

at least cite some sources, never heard of this...you have to be careful a lot of times when people talk about HA they're talking about injections, not the stuff for bone augmentation
Title: Re: Hydroxyapatite binds to skin?
Post by: Lazlo on December 13, 2013, 08:00:39 AM
what happened to all those consults with coceancig you were supposed to have player?
Title: Re: Hydroxyapatite binds to skin?
Post by: Modigliani on December 13, 2013, 09:38:06 AM
at least cite some sources, never heard of this...you have to be careful a lot of times when people talk about HA they're talking about injections, not the stuff for bone augmentation

Yeah, I've noticed that it can often get confused with the injectable, Radiesse.
Title: Re: Hydroxyapatite binds to skin?
Post by: Lord-of-the-Cartilage on December 13, 2013, 02:39:03 PM
I assume he means the solid HA used in maxfac surgery, the variant used for fillers would mostly dissolve and therefore not have a long term impact on how someone's soft tissue ages.

He probably heard this from a surgeon who wants to up the surgical fee.
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 13, 2013, 04:25:31 PM
at least cite some sources, never heard of this...you have to be careful a lot of times when people talk about HA they're talking about injections, not the stuff for bone augmentation

I'll dig it up tonight and post it here
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 13, 2013, 04:30:22 PM
what happened to all those consults with coceancig you were supposed to have player?

I got screwed over by my ortho somewhat.

We were supposed to talk about my options regarding my cant as well as a few other things, and be given a referral to a surgeon. In the end all he did was hand me some no-name surgeon's business card after adjusting my braces. I'm starting to think there's something holding him back from writing an actual referral.


Title: Re: Hydroxyapatite binds to skin?
Post by: PloskoPlus on December 15, 2013, 02:31:33 AM
I got screwed over by my ortho somewhat.

We were supposed to talk about my options regarding my cant as well as a few other things, and be given a referral to a surgeon. In the end all he did was hand me some no-name surgeon's business card after adjusting my braces. I'm starting to think there's something holding him back from writing an actual referral.

coceancig has a dentist onsite (in Newcastle for certain) who can write a referral on the spot.  Also they have a CT  scan machine and will bulk bill the scan.

Title: Re: Hydroxyapatite binds to skin?
Post by: sean89 on December 17, 2013, 01:36:49 PM
I have quite a narrow jaw so am interested in the potential of hydroxy along the jawline (I know it has a multitude of uses). But when I spoke to a surgeon today, he pretty much said that, if you want a wider jaw, you have two options: option A - orthognathic surgery - but the difference to the width of the face is negligible. Or option B - jaw implants - the only thing that will give you a chiselled jawline.

His reason for being dismissive about hydroxy was that it could crumble and implants actually provided more stability as well as definition. I just wonder though how much of his opinion was coloured by the technical difficulty of applying the hydroxy to the jawline (which he mentioned), and so rather than go through the ballache of applying it when the results are quite subtle, he'd rather use implants. That's me just speculating though. He was also dismissive about fat transfer.

Hopefully, distraction of the ramus (whatever it is) can be developed in the future to produce solid results otherwise, I think there's few options available to augment the jawline, but I'm still 50/50 about the use of hydroxyapatite.

I'm probably not as well read as others on the subject so please let me know if I've forgotten any other options to enhance the jawline (not including the chin).
Title: Re: Hydroxyapatite binds to skin?
Post by: Tiny on December 17, 2013, 06:02:30 PM
It's a shame custom titanium implants are so $$$$$.  In a few years it will come down, because the 3D printing technology will be better/used more often
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 18, 2013, 06:05:31 AM
Where I read it: http://www.makemeheal.com/answers/viewQuestion.do?qid=4322 (http://www.makemeheal.com/answers/viewQuestion.do?qid=4322)

Interestingly enough a New Zealand website claims that the granules don't get bone reabsorption, only HA implants as the paste is non-porous.

http://www.dermnetnz.org/procedures/hydroxyapatite.html (http://www.dermnetnz.org/procedures/hydroxyapatite.html)

Is the soft-tissue ingrowth possibly referring to what the person in the first link was talking about?
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 18, 2013, 07:38:03 AM
I have quite a narrow jaw so am interested in the potential of hydroxy along the jawline (I know it has a multitude of uses). But when I spoke to a surgeon today, he pretty much said that, if you want a wider jaw, you have two options: option A - orthognathic surgery - but the difference to the width of the face is negligible. Or option B - jaw implants - the only thing that will give you a chiselled jawline.

His reason for being dismissive about hydroxy was that it could crumble and implants actually provided more stability as well as definition. I just wonder though how much of his opinion was coloured by the technical difficulty of applying the hydroxy to the jawline (which he mentioned), and so rather than go through the ballache of applying it when the results are quite subtle, he'd rather use implants. That's me just speculating though. He was also dismissive about fat transfer.

Hopefully, distraction of the ramus (whatever it is) can be developed in the future to produce solid results otherwise, I think there's few options available to augment the jawline, but I'm still 50/50 about the use of hydroxyapatite.

I'm probably not as well read as others on the subject so please let me know if I've forgotten any other options to enhance the jawline (not including the chin).

I think DO on the ramus can't really be developed. We discussed this in another thread. If you are lengthening the rami you'll be dropping the jaw. So how are your teeth supposed to meet then?

As far as I can tell the best options for bad jaw and rami would be:

IVRO if you have an open bite. This can improve gonial angles quite a bit and give a squarer jawline.

Or Implant.

Compare implant results and it's clear that in anything above a minor case the implants give significantly better aesthetic results. HA paste won't give you the projection you seem to need or want.
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 18, 2013, 07:40:15 AM
It's a shame custom titanium implants are so $$$$$.  In a few years it will come down, because the 3D printing technology will be better/used more often

So is it the printing that makes them so expensive? The titanium? Or a combination of the two?

Perhaps in the future we'll be using our home 3d printers to create our own jaw implants  ;D
Title: Re: Hydroxyapatite binds to skin?
Post by: sean89 on December 18, 2013, 10:41:18 AM
Titanium implants are expensive but the price that I've heard for them is a drop in the ocean next to the price paid for orthognathic surgery in the U.S which is, imo, outrageous.
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 18, 2013, 08:30:39 PM
Titanium implants are expensive but the price that I've heard for them is a drop in the ocean next to the price paid for orthognathic surgery in the U.S which is, imo, outrageous.

Got any rough figures to give? I've only been told they're expensive, never an exact price.
Title: Re: Hydroxyapatite binds to skin?
Post by: sean89 on December 18, 2013, 08:57:05 PM
7500GBP
Title: Re: Hydroxyapatite binds to skin?
Post by: Tiny on December 19, 2013, 02:48:16 PM
Titanium implants are expensive but the price that I've heard for them is a drop in the ocean next to the price paid for orthognathic surgery in the U.S which is, imo, outrageous.

Thought it was more than that for custom titanium - around $15k, or ~10k GBP...will depend on the surgeon I guess

Will try get a quote from MM if I see him again
Title: Re: Hydroxyapatite binds to skin?
Post by: Optimistic on December 19, 2013, 04:59:13 PM
Thought it was more than that for custom titanium - around $15k, or ~10k GBP...will depend on the surgeon I guess

Will try get a quote from MM if I see him again

Do you think there'd be much of a difference between an actual titanium jaw implant that covered the entire mandible border, and say one that just went at the back of the jaw to improve jaw angle and gonial angles?