jawsurgeryforums.com
General Category => Aesthetics => Topic started by: Lestat on December 16, 2016, 04:53:09 AM
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I have read that because the paste is rough, it could damage the tissue and skin on top. I only read that in one place and didn't bookmark the page, now I cant find it again! :-\
What do you guys think?
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I saw a 3D CT scan somewhere on Dr. Eppley's website of a guy who had HA injections and the bone underneath was all eroded/remodeled and completely ruined. I don't know why people would want to get HA. I'm not sure about the tissue on top.
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I basically wouldn't trust anyone other than Gunson or maybe Deschamps Braly with HA paste, but that's just me from reading this forum.
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I saw a 3D CT scan somewhere on Dr. Eppley's website of a guy who had HA injections and the bone underneath was all eroded/remodeled and completely ruined. I don't know why people would want to get HA. I'm not sure about the tissue on top.
thats odd when i saw eppley he only said great things about HA. also where was it placed
he also put a post on his blog awhile back on how safe ha was in response to the thread here saying how dangerous it was. i know dr sinn told me (as dideppley) there are different preperations of ha and types
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http://exploreplasticsurgery.com/hydroxyapatite-granules-facial-augmentation/
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http://exploreplasticsurgery.com/hydroxyapatite-granules-facial-augmentation/
That's a really good article and clarifies a lot of things. As I thought HA is okay for very small augmentation but as Eppley states, it is best used when not asked to "do too much." --and thus it is of limited aesthetic use on the face.
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thats odd when i saw eppley he only said great things about HA. also where was it placed
he also put a post on his blog awhile back on how safe ha was in response to the thread here saying how dangerous it was. i know dr sinn told me (as dideppley) there are different preperations of ha and types
http://exploreplasticsurgery.com/plastic-surgery-case-study-custom-jawline-implant-in-surgically-altered-mandible/
(http://exploreplasticsurgery.com/wp-content/uploads/2015/02/Sliding-Genioplasty-and-HA-Granule-Jawline-Augmentation-Dr-Barry-Eppley-Indianapolis.jpg)
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Another statement from B.L.Eppley:
"The problems with demineralized bone or hydroxyapatite granules for cheek augmentation, or any location of facial bone augmentation, is the inconsistency of the shape that results. Granular materials will have a tendency to clump or become lumpy and not have the smooth contour that a preformed implant does. It may work successfully for small areas of cheek augmentation but is not reliable for larger or more anterior cheek locations."
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It's difficult to find photos of HA augmentation. This guy had HA plus fat transfer--I think it's an improvement:
http://www.facialsculptureclinic.com/en/case/all-cases/114/
this one had just HA:
http://www.facialsculptureclinic.com/en/case/jaw-surgery/cheekbone-augmentation/209/
and this:
http://www.facialsculptureclinic.com/en/case/jaw-surgery/cheekbone-augmentation/21/
Arnett and Gunson use it all the time and they are supposed to be the best, so it can't be that bad, right?
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It's difficult to find photos of HA augmentation. This guy had HA plus fat transfer--I think it's an improvement:
http://www.facialsculptureclinic.com/en/case/all-cases/114/
this one had just HA:
http://www.facialsculptureclinic.com/en/case/jaw-surgery/cheekbone-augmentation/209/
and this:
http://www.facialsculptureclinic.com/en/case/jaw-surgery/cheekbone-augmentation/21/
Arnett and Gunson use it all the time and they are supposed to be the best, so it can't be that bad, right?
I don't like those results at all. Soft with no discernible shape. Weak . FEEBLE .
Many doctors think that results like this are "natural" as if soft must be synonymous with natural.
Well men are born with naturally high sharp and chiselled bones, that is what I endeavour to create.
Too many surgeons lack ambition.
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Looks shockingly bad. I was seriously thinking of having this put on my brow, I'm now having major second thoughts.
(http://67.media.tumblr.com/tumblr_lthgwohL3E1qzwnrqo1_500.png)
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(...) "The radiological evaluation showed that 99.7% of the hydroxyapatite augmentation was maintained at 2 years when compared to the 3-month baseline measurements. The t test showed no statistical difference. There was no radiographic evidence of soft tissue atrophy or native bone resorption on the 1- and 2-year scans. Overall projection (bony and soft tissue) was maintained at the 2-year follow-up".
The overall projection (bony and soft tissue) was maintained as there was no evidence of native bone resorption or soft tissue atrophy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906722/
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Looks shockingly bad. I was seriously thinking of having this put on my brow, I'm now having major second thoughts.
That's only one method of preparation. I've heard of cases where it was put on brow and made a very aesthetic improvement. So I'm not sure if what we see in this x-ray is true across the board for HA paste. Certainly it's not for the way Gunson and Arnett use it.
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I would never use HA for jawline augmentaion. I know someone from missj who had it with a cosmetic surgeron and it looked horrible. HA is a known material to use in the brow augmentation.
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http://exploreplasticsurgery.com/plastic-surgery-case-study-custom-jawline-implant-in-surgically-altered-mandible/
(http://exploreplasticsurgery.com/wp-content/uploads/2015/02/Sliding-Genioplasty-and-HA-Granule-Jawline-Augmentation-Dr-Barry-Eppley-Indianapolis.jpg)
The problem is i would need to know more about this case. who did his HA etc. i notice some of the damage is on top of the area that has HA. maybe ha caused it maybe he didnt. for all we know this guys jaw bone was damaged prior or that was natural .
I had a long conversation with dr. sinn on HA and Eppley . There are diff types of HA granules, cement etc. different companies. in response to the HA moammerts cases they said lord know what he used, fine it was HA but what company, how was it prepared, did he add anything to it etc.
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The problem is i would need to know more about this case. who did his HA etc. i notice some of the damage is on top of the area that has HA. maybe ha caused it maybe he didnt. for all we know this guys jaw bone was damaged prior or that was natural .
I had a long conversation with dr. sinn on HA and Eppley . There are diff types of HA granules, cement etc. different companies. in response to the HA moammerts cases they said lord know what he used, fine it was HA but what company, how was it prepared, did he add anything to it etc.
So are you in favor of HA if done by Sinn?
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I'm not really following here, if the bone looks a bit marbly or however you want to describe it, that probably wouldn't show through unless your super old? It can't be smoothed out? Supposedly a medpor implant could be shaved even after it's been in one's chin (per Dr. Stephen Warren), so why not HA if its applied directly to the bone?. And if you for whatever reason wanted an implant down the line, can't you just get a custom one that would sit properly over the HA paste but outwardly give a normal, smooth implant 'look'?
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prometeus: if the bone displacement is at least 3-4mm you can do osteotomy. You can send me your DICOM files (CT) and some important photos (typical views) of you and I will be able to calculate exactly how the bone moved after fracture with only 0.5-1mm error
If you have CT before fracture that it makes everything easy
if you want to undergo zygomatic bone reposition, you have to look for a doctor specialised in orbital reconstruction as this is crucial thing when it comes to zygomatic bone repositions. You have 1% chance you will end up with permanent double vision ..when that happen, your surgeon will have to repair that. It's rare but it can happen. Of course such surgeon should have several zygomatic bone repositions by osteotomy in his career. It's rare procedure - you have to know that
and you risk additional damages to your infraorbital nerve ..if it has been already compressed and you lost a bit of feeling
Such procedure for sure is better than HA - more professional, but at the same time a bit more risky for nerves and your eye.
HA paste in not free from long-term side effects
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http://exploreplasticsurgery.com/plastic-surgery-case-study-custom-jawline-implant-in-surgically-altered-mandible/
(http://exploreplasticsurgery.com/wp-content/uploads/2015/02/Sliding-Genioplasty-and-HA-Granule-Jawline-Augmentation-Dr-Barry-Eppley-Indianapolis.jpg)
Has anyone actually asked eppley about this case and if HA cause that jaw to be deformed? Its a case publicly shared on his blog so there shouldn't be any issues with answering questions.