jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Lestat on February 20, 2017, 11:04:22 AM
-
(Jaw) implants are very powerful, but the question of bone resorption is still NOT answered yet.
You find many old reports stating that it will happen, but also alot of statements of surgeons saying its not happening anymore with new implant design & material.
We need to do some more research and find a definite solution to this because not doing custom jaw implant is ridiculous given the amazing results, but having bone resorption and losing 3 or 4 mm per side is also f**ked!
-
My opinion regarding bone erosion and implants:
The only facial implant type that shows bone erosion is chin implants. Every other type (jaw, cheek, etc.) distinctly does not. Previously this was considered problematic because earlier chin implant designs did not evenly disperse pressure across where they settled, so significant erosion could occur. Modern anatomic designs have eliminated this issue - there will sometimes be an insignificant amount of "settling" that is just the bone adjusting to the pressure from the implant. Of all the (valid) reasons to hesitate before getting a facial implant, this should not be one of them.
As for the use of HA paste for augmentation, it typically isn't used for significant augmentation and for good reason.
What do you guys think?
-
What if you have an anatomic chin, aka one that doesn't have wings? Does that not distribute the force and in turn result in the infamous chin bone erosion?
I got the XL of this: https://www.implantech.com/newsite/home/115-anatomical-chin.html
-
Eppley told me all implants cause erosion. They are his bread and butter and he still said that.
A: The simple answer to almost everyone of your jaw angle implants concerns is that none of them are true or are based in any biologic or clinical reality. While it is true that jaw angle implants are placed under the masseter muscles, this does not lead to chewing or muscular dysfunction, underlying bone erosion, or aesthetically undesireable scar tissue formation.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com/jaw-angle-implants
-
A: (...) I am not aware that there is any bony erosion with jaw angle implants. I have removed many from other surgeons over the years and have never seen that issue.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com/is-the-risk-of-infection-greater-when-placing-jaw-angle-implants-in-someone-who-has-had-jaw-angle-reduction-previously
-
My surgeon has also mentioned that he used to do chin implants more often (medpor) but has since stopped almost completely due to the infection rate, bone resorption, and other long term issues. He now does sliding genioplasty wth a bone graft from the illiac crest of the hip, which he told me has no long term negative effects (debatable).
However, for the jaw angles, he stated he also prefers to use bone grafts, even though the ammount of bone that "takes" is unpredictable, which can result in asymmetry. he says he prefers this because the medpor implants for jaw angles have an infection rate of about 10% (as confirmed by lestat earlier). Another surgeon he works with mentioned that, even decades later, if you get a tooth infection or anything of the sort, your implant may need to be removed, which, after soft tissue and bone integration, is a f-ing nightmare.
-
Dr Z told me jaw implants are "f**king terrible".
Eppley told me all implants cause erosion. They are his bread and butter and he still said that.
Sinn told me he no longer does implants because long term he had too many patients come back requiring removal due to infection. And when removed the host bone was fragile.
Etc.
Eppley states on his website that bone erosion is unique to chin implants due to the specific anatomical circumstances of that region and that it doesnt happen with any other facial implant.
Interesting that sinn claims to have so many infections. I wonder what material he used and what techniques he used to install them, infection is low in the literature, including for the ones people seem to perceive as being "dirty" for whatever reason, like medpor.
Z also told me implants never look natural etc, which is not entirely true, but I would agree most of the ones i have seen leave me very underwhelmed. That said, a side wing might be ideal but its also what, 5mm lateral on average? Most guys need about 10mm to get a "strong" jaw angle i would propose.
-
i saw great results from medpor, i must say. Side wing or chin wing is awesome but should be repeated most of the times. i had it twice and i need fillers every 6 months.
So it's a preference really. if you go the "Natural" route prepare for 2 surgeries (depending on starting point) and perhaps fillers. Medpor may build up all of your bone structure in one take...it's a tough choice to be honest, wouldn't know what to recommend
-
i saw great results from medpor, i must say. Side wing or chin wing is awesome but should be repeated most of the times. i had it twice and i need fillers every 6 months.
So it's a preference really. if you go the "Natural" route prepare for 2 surgeries (depending on starting point) and perhaps fillers. Medpor may build up all of your bone structure in one take...it's a tough choice to be honest, wouldn't know what to recommend
Hi! May I ask how long was the duration between your two chin/side wings?
Also the lateral gain could you quantify it in terms of mms? Thanks.
-
Jesus! :o With this revolutionary jaw implant made of titanium no bone erosion would happen! :P
http://www.xilloc.com/patients/stories/total-mandibular-implant/
-
There is no erosion with calcium phosphate.
-
calcium phosphate is so brittle a tiny impact would cause it to shatter in your face.
-
yeah seriously that whole xilloc/companies making the implants with HA s**t ---totally useless.
-
yeah seriously that whole xilloc/companies making the implants with HA s**t ---totally useless.
i wouldent say totally useless. the innovations are creating progress towards better implant materials with higher levels of osseo integration. a few years down the line theyl have materials that turn into real bone thats harder better stronger than native bone. its coming. too bad youth is fleeing for us...
-
i wouldent say totally useless. the innovations are creating progress towards better implant materials with higher levels of osseo integration. a few years down the line theyl have materials that turn into real bone thats harder better stronger than native bone. its coming. too bad youth is fleeing for us...
I know all too well from hair loss forums, that in the medical industry the "next big thing" is always "in a few years" and will be "revolutionary".
-
I know all too well from hair loss forums, that in the medical industry the "next big thing" is always "in a few years" and will be "revolutionary".
youre correct i suppose. it happens more as gradual progressions as opposed to a revolutionary discovery. hair transplants have come such a long way since i started losing my hair about 8 years ago. by the time i get a transplant im sure itl look like im 17 again
-
youre correct i suppose. it happens more as gradual progressions as opposed to a revolutionary discovery. hair transplants have come such a long way since i started losing my hair about 8 years ago. by the time i get a transplant im sure itl look like im 17 again
Hair Transplants aren't very advanced at all or that solution isn't. I know surgeons who charge above 60 K and give artificial results. The drug companies will make sure there is no cure, same for cancer.
They CAN give great results but we should be much more advanced in the hair loss field by now.
-
Hair Transplants aren't very advanced at all or that solution isn't. I know surgeons who charge above 60 K and give artificial results. The drug companies will make sure there is no cure, same for cancer.
They CAN give great results but we should be much more advanced in the hair loss field by now.
ya the drugs make pharma companies so much money that a transplant that perma fixed it would cut into their profits.
free market my ass
-
calcium phosphate is so brittle a tiny impact would cause it to shatter in your face.
It's not optimal but still far better then any other option available now and for long. Any superior material would involve cell tehcnology which would be painstakingly long to get approved for commercial use. And that's only when they even can get the techology to work. Waiting and holding off for the perfect solution isn't the right choice because by the time it arrives, you would have lost substantially of your looks-baseline because of aging. You would then only playing catchup with your baseline. Catch 22. Youth and time is crucial in maxing out your surgeries.
-
calcium phosphate is so brittle a tiny impact would cause it to shatter in your face.
What if the implant was small, say a paranasal implant or other.
Even if it was brittle it wouldnt have enough surface area to break from an impact, unless it was hard enough to crush bone anyway.
-
i wouldent say totally useless. the innovations are creating progress towards better implant materials with higher levels of osseo integration. a few years down the line theyl have materials that turn into real bone thats harder better stronger than native bone. its coming. too bad youth is fleeing for us...
well these innovations will give us some more youth at least superficially. but as some of the younger bucks on this forum will discover, the older you get the more fatalistic you become, the less you care, the less you desire. There's f**king nothing like the bloom of youth I'll tell ya
-
well these innovations will give us some more youth at least superficially. but as some of the younger bucks on this forum will discover, the older you get the more fatalistic you become, the less you care, the less you desire. There's f**king nothing like the bloom of youth I'll tell ya
I've been told that new experiences are the most potent under the age of 25. Any new experiences after that age are "meh". Just the way the brain works.