jawsurgeryforums.com
General Category => General Chat => Topic started by: molestrip on April 01, 2015, 09:27:13 AM
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We've been touching on the topic of implants and augmentations in a few posts. I consulted a plastic surgeon yesterday who works with HA and he said he still doesn't use it much simply because the results aren't that great. He said it's not replaced by bone and it sounds great and biocompatible but it's really just as foreign to the body as anything else. He said it was very popular in the 80s. So that's the story on why more surgeons aren't doing that kind of work anymore.
I mentioned once the idea of implants made with real bone. This is possible today really, unfortunately I didn't ask why we aren't seeing it yet. I'd guess it's just a matter of regulatory approval and adaption of the product for this purpose. We already have the software and tooling to customize implants so doing it with real bone shouldn't be much of a challenge. Two products I've seen recently that could work this way are epibone (http://epibone.com/) and allostem (http://www.allosource.org/products/allostem-cellular-bone-allograft/). That's just what I've stumbled upon, I'm sure there's much more here. This is already a very large market but I get the impression facial implants are small beans compared to spinal and trauma work. I think it's only a matter of time before you get essentially a free custom autograft that you could layer where you like. If you don't like it, then you can remove it before the bone grows into it. The need for post-implant moldability is reduced through computer modeling including soft tissue changes. In a osteoconductive product like this, I would think that you could use biodegradable screws but otherwise I don't see why an osteocoductive glue or cement wouldn't work either. It'd be cool to see this stuff used in jaw surgery even, someone just has to pioneer it.
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That would be awesome; it'll be really exciting to see this happen...and coupled with advances in bio-3D printing the results could be spectacular. One day...
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I get the impression 3d printing is better for soft tissue. Not sure it works well for bone. I would think, grow the thing in the lab and then etch it to the right shape. Looking at epibone again, looks like they're basically taking a scaffold like allostem and replicating the growth outside the body. That's a huge win of course. Typically, a product like this takes 5 years to become commercially available, maybe another 5 until it hits other applications. I doubt facial implants will be first in line.
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It'll be availble --but i'm gonna be optimistic and say 50 years from now.
Also, one of the main problems is everyone's soft tissue reacts very differently to implants or augmentation and so there is still a high degree of unrpedictability involved. Talking about this stuff may feel like hope, but it's just gonna come soon enough for any of us.
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ya this stuff looks amazing! Kind of makes you wonder whether you should just take the less invasive procedure and wait for something like this in the future.
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I don't know about less invasive. Safer and more permanent would be more like it. Still the same but hopefully lower risks as existing products. You never know I suppose but anything that will be available within 5 years you should have an inkling about today.
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I don't know about less invasive. Safer and more permanent would be more like it. Still the same but hopefully lower risks as existing products. You never know I suppose but anything that will be available within 5 years you should have an inkling about today.
God if this stuff could be available in five years to really redesign your face from a structural standpoint I'd be over the moon. I mean you look at a guy like George Clooney. His bone structure in real life I bet seems almost over-exaggerated. His chin is gigantic and his cheekbones very prominent. When he was young his face almost looked like it was shaped by a razor. In addition to great skin and hair, many that guy at 60 will still be "Gorgeous George". How wonderful it would be if one could re-design oneself towards an aesthetic ideal. But these are fantasies I fear.
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Eh. I'd still rather be a hot lesbian. Girls have all the fun :) I've read some scary stats about men and sexual function, starting in 30s! Apparently like half of men have trouble with erections by 40s even. The reverse has happened to me, as severe OSA destroyed my testosterone in my 20s and now that it's treated sex is like all new to me.
Don't forget, btw, that the first people would be getting this stuff in 5-10 years. You might not want to be first.
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Eh. I'd still rather be a hot lesbian. Girls have all the fun :) I've read some scary stats about men and sexual function, starting in 30s! Apparently like half of men have trouble with erections by 40s even. The reverse has happened to me, as severe OSA destroyed my testosterone in my 20s and now that it's treated sex is like all new to me.
Don't forget, btw, that the first people would be getting this stuff in 5-10 years. You might not want to be first.
That's very interesting, you had obstructive sleep apnea that lowered your testosterone? And now with a CPAP your testosterone has been treated or do you receive testosterone injections? Just curious since we're discussing general health.
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Since we're talking about general health, OSA will break just about everything and make life generally miserable. Testosterone is normal again with CPAP, no need for supplementation.
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@ molestrip - I meant less invasive procedure as in le fort I
Also is there any proof OSA effects testosterone, sounds kinda far out there. Im worried because I have symptoms of low test, and most likely have the beginnings of OSA.
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Oh yes, it's a reasonable option to consider I think and the one most people are taking, whether they realize it or not.
Yes, there is proof that OSA affects testosterone. ED is listed as one of the side effects. I don't have the references handy but it's not hard to find from Google or Pubmed searches.
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yeah molestrip is correct. OSA can create problems ranging from low test, to depression, to all sorts of horrible symptoms.
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I read a study recently that men who are sick actually tend to prefer women with less feminine features too.
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I read a study recently that men who are sick actually tend to prefer women with less feminine features too.
Consider me a sick puppy then.
(http://en.wikipedia.org/wiki/Terry_Farrell_(actress)#/media/File:Terry_Farrell_by_Tim_Drury_(2009).jpg)
http://en.wikipedia.org/wiki/Terry_Farrell_(actress)#/media/File:Terry_Farrell_by_Tim_Drury_(2009).jpg
She could easily be made into a good looking man. Tremendous skull.
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Yes, there is proof that OSA affects testosterone. ED is listed as one of the side effects. I don't have the references handy but it's not hard to find from Google or Pubmed searches.
It has to be very severe OSA to do that. What's your AHI ?
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My AHI was 50 last time it was measured.
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I just measured my ceph airway at its most narrow point and it was 6-7mm. Is that bad?
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10-12mm is reference range
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That's the anecdotal number, there's a few spots of obstruction. A/G has the best list of norms (http://www.arnettgunson.com/fab-treatment-planning/airway/sleep-apnea-diagnosis/cephalometric-airway-measurement) that I've seen. The more spots you obstruct, the higher the AHI. Degree of obstruction isn't significant to the AHI but it could mean the difference between UARS, hypopneas, and apneas.
Also, everyone's airway is different. The big factor is how much soft tissue do you have that the skeleton is intended to hold up. You can kind of approximate it by looking at the tissue on the outside. Is the skin under the mandible well supported, tight like you see on models? Or is it kind of double-triple chinny? My airway is 9mm at its narrowest and I have a high AHI. By contrast, I know of 3mm cases that have no OSA (but it's very rare). The other thin to remember is that weight gain and age (through sagging) shrink your airway over time. Some even think that everyone develops OSA at some age and the high normal AHI labs look for is an indication of that. A smaller airway simply means that you get it sooner than others would. Unfortunately, there appears to be no studies done on predicting who will develop OSA and when so as of now, no surgeon could in their right mind suggest an MMA for you to correct a problem that can't be diagnosed even though anecdotally we know that there's a good chance that in the future, when you're a worse candidate for it, you'd likely need it. Worse yet, we don't know how much to advance you to fix the problem because we lack the models. Fortunately, there's a limit to how much they can advance you in practice so that tends to be the number, no matter the aesthetic compromise. Some surgeons go by the philosophy of "making you look like everyone else", that is correcting the deviations, not making your airway as large as possible.
But to keep things simple, yes I'd say that's pretty small.
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wow she's still hot! played DAX on deepspace 9 man i loved her. wow.
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Yes but have you seen her eating a hamburger?
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no but i'd love to.
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Typically they advance 10mm measured at the teeth or 12-13mm at the chin (sometimes more w/genioplasty). It stretches the nerve but it usually heals, not always 100%.