jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: dardok on March 12, 2017, 07:57:41 PM
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If such a thing does not exist then I can't imagine why people would opt for this type of procedure.
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lypholized cartilage looks good.
native bone grafts work but cause asymetry because we cant predict how much bone will take.
other than that, no there is not. all materials have pros and cons.
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the infection rate is extremely low for pretty much all the popular materials.
Any surgery can trigger an infection, any foreign body can trigger an infection. Titanium is about the most ideal material you can get, and even that has the possiblity of infection, as Lazlo can tell you firsthand.
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i think medpor has 10% risk of infection at the jaw implants. you cant just stick big slabs of titanium to cause contour augmentation because of bone resorption.
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I would be wary of medor implants in the jaw. I have heard they really stick to the bone and if it gets infected it is hard to take out.
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I would be wary of medor implants in the jaw. I have heard they really stick to the bone and if it gets infected it is hard to take out.
A maxillofacial surgeon told me there is no problem with taking out medpor implants, they did it many times and they weren't even selling medpor implants so no reason to lie.
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A maxillofacial surgeon told me there is no problem with taking out medpor implants, they did it many times and they weren't even selling medpor implants so no reason to lie.
I was told the same.
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I was told the same.
Interesting, do you know if there are actually any studies that reference difficulties with removing medpor? Then again maybe there are laws that any study regarding medpor has to have the company's consent?
The surgeon looked genuinely perplexed when I mentioned to her that there are rumors about it being difficult to remove. She had worked in a university that used it for years.
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I would be wary of medor implants in the jaw. I have heard they really stick to the bone and if it gets infected it is hard to take out.
This is frequently brought up whenever implants are discussed but no one ever seems to talk about the benefits of medpor.
Namely that it provides a superior aesthethic result to silicone (thats not my opinion - ive had that confirmed by TWO of the big names in alloplastic augmentation now. That s**t Eppley keeps spewing is WRONG), and the integration decreases the chances of long term infection (blood supply through tissue ingrowth). The adherence/ingrowth also means little to no erosion.
The obvious benefit of silicone is easy removal in cases of complication or revision, and that is why inexperienced/unconfident doctors and unconfident patients like it so much - it offers an easy "out" if anything goes wrong. But Ive been looking into this for a long time, and nearly every single silicone implant result for jaw augmentation has been s**t. The person just looks bloated after. There are about 2 results i would consider acceptable, and maybe only 1 that i would consider money well spent - but that one I'm not even sure if it was silicone (it was the famous terino result in case anyone is wondering. But the guy also had a lot more done than just jawline).
Conversely, I haven't seen a lot of medpor results, but the ones I have, are all GOOD.
(http://scielo.isciii.es/img/revistas/cpil/v33n3/143_fig8.jpg)
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Agree with everything you said ppsk.
That guy had a great result, I think it was Terrino right?
Dramatic but natural looking, exactly what most guys on here want.
Interestingly, Sailer mostly uses medpor for jaw implants not cartilage unless it is a small augmentation. Must be a reason for that.
Silicone implants give awful results whether it is jaw chin or cheek implants, fake and bloated looking.
What does Dr Y use?
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Agree with everything you said ppsk.
That guy had a great result, I think it was Terrino right?
Dramatic but natural looking, exactly what most guys on here want.
Interestingly, Sailer mostly uses medpor for jaw implants not cartilage unless it is a small augmentation. Must be a reason for that.
Silicone implants give awful results whether it is jaw chin or cheek implants, fake and bloated looking.
What does Dr Y use?
That result i posted was from Ramirez I'm pretty sure.
Yaremchuk uses both I believe. I think his selection like most doctors who use both, probably depends on how paranoid the patient is about complications.
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It makes little difference to the aesthetic outcome whether you use Medpor or Silicone. For some reason the top Euro surgeons tend to favour Medpor over Silicone and the results are just as crap.
I've heard stories from surgeons where Medpor had to be drilled off the skull because it was so deeply osseo-integrated.
The long term infection rate is about the same. Maybe a couple of percent lower for Medpor according to different studies.
Medpor implants are easier and cheaper for the surgeon to customise to the patient.
Silicone facial implants are actually hard. They won't be significantly compressed out of shape by facial musculature.
For people considering jaw angle implants I have an alternative which uses your own bone. I will be sharing my plan and the surgeon after I get my LF3.
Why dont you just share the technique, why is there all this f**king secrecy on this forum
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Why dont you just share the technique, why is there all this f**king secrecy on this forum
People are afraid the prices will go up if the demand for the procedure increases. ::)
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We are all here to learn and share knowledge, neither will happen by insulting each other.
I disagree that silicone can give the same results as medpor, silicone IS a soft material and its shape is determined by its soft constitution.
Most surgeons don't use medpor, if we are talking about plastic surgeons then they use silicone, in the US and Europe.
Pretty much only people like Dr Y, Dr R, Sailer, Dr T and Eppley that use medpor or ct implants. Of course there are others but mainly maxillofacial surgeons and good ones.
I understand why you don't want to divulge your surgeon or procedure yet but you can also understand ppsk's frustration.
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The silicone used in breast implants is pretty soft. The silicone used in facial implants is not. Have you squeezed a silicone chin implant in your fingers before? I think you will be surprised if you haven't. A 10mm jaw angle implant is not going to be substantially deformed out of shape. I find it humorous people believe that. There's x-rays online of jaw implants and you can see the implant sitting there in shape. There's after pictures of jaw implants clearly and sharply extending the vertical length of the ramus with no deformation. And so on.
The surgeons I've consulted in Europe that do jaw angle and custom mid-face implants all did Medpor exclusively with the exception of one. The two main reasons given were no infection risk (not true but they still said it) and that it's easier to customise for the patient. I was never told medpor is superior because it's harder and therefore deforms less under musculature pressure.
My opinion, and of course it's just my opinion, is the reason for poor jaw implant results is due to a host of other reasons. One being it's simply a challenge to get right. Another reason is due to muscles and soft tissue. The shape and size of the masseter muscle which lays on top of the implant varies substantially amongst individuals, for example.
What would be, in your opinion the best implant material for midface augmentation? Specifically paranasal. I'm looking for no erosion resorption and no infection risk that sits well on the skin and maintains its structure.
That is alot to ask I know but which material would be able to come close.
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The silicone used in breast implants is pretty soft. The silicone used in facial implants is not. Have you squeezed a silicone chin implant in your fingers before? I think you will be surprised if you haven't. A 10mm jaw angle implant is not going to be substantially deformed out of shape. I find it humorous people believe that. There's x-rays online of jaw implants and you can see the implant sitting there in shape. There's after pictures of jaw implants clearly and sharply extending the vertical length of the ramus with no deformation. And so on.
The surgeons I've consulted in Europe that do jaw angle and custom mid-face implants all did Medpor exclusively with the exception of one. The two main reasons given were no infection risk (not true but they still said it) and that it's easier to customise for the patient. I was never told medpor is superior because it's harder and therefore deforms less under musculature pressure.
My opinion, and of course it's just my opinion, is the reason for poor jaw implant results is due to a host of other reasons. One being it's simply a challenge to get right. Another reason is due to muscles and soft tissue. The shape and size of the masseter muscle which lays on top of the implant varies substantially amongst individuals, for example.
Dr R to me:
"You are correct. Medpor gives a sharper and more defined look. It also produces minimal or none bone erosion. Silicone produces significant bone erosion particularly under the pressure of the strong masseter muscle. I will send you a rough draft explaining this and other comparative features."
He only prefers use silicone in areas where the ingrowth of medpor is actually a huge problem - probably the nasal area I am guessing.
In the documents he sent me, medpor is harder to modify in the surgical room, requires a bigger incision and is more complex to install. This is consistent with what other surgeons say about medpor, and why they prefer silicone - they sometimes even fold it to get it through the small incision, something not possible with medpor. Medpor is also more expensive than silicone.
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There is no such thing as no infection risk. Don't believe anyone who says otherwise. Even a bone graft taken from your own skeleton and placed elsewhere can cause an infection.
Resorption is a fiercely debated topic. You will notice that top surgeons disagree with each other on it. I would imagine resorption in the paranasal area would be minimal. How many mm do you require?
What I can tell you is the closer an implant is to the nose and sinuses, the greater the chance of infection. This has been deduced from studies on the rate of infection with facial implants.
I saw paranasal augmentation with HA a while back and the results were quite decent. Good HA powder will be 50% replaced with bone in the long run. But it's for small jobs.
I'm looking to minimize erosion and resorption, The implant is no more than about 5mm by my estimate.
From what I see HA is the best option but I'm not so certain its obtainable in Canada.
What are some surgeons who specialize in HA implants?
The infection I'm worried about isn't post surgery, but long term infection, and what are the rates of that with HA?
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Never saw the hate with jaw implants. Almost all of the results by the top surgeons look phenomenal. I have yet to see a chin-wing result where the rami was widened from the front view. I think people are too concerned with the fact that they feel they are using temporary solutions to cover problems. BSSO can add jaw width from what I have seen but the difference is minimal. Jaw implants barely get infected and cause bone erosion, I have researched this and talked to surgeons. Your own bone graft can also get infected too.
It's not like anyone is going to go up to us in public and put an x-ray up to our jaw. I am most likely going to get jaw implants just to add a little more width. Unless I see more results of chin wings where the jaw was widened. You would probably need atleast 2 of them though.
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hmmm if to live is to die, I can't imagine why most people want to live..
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Never saw the hate with jaw implants. Almost all of the results by the top surgeons look phenomenal.
Actually there are very many which look awful, the number of bad jaw implant results outweigh the decent
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http://jawsurgeryforums.com/index.php?topic=6538.0
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It makes little difference to the aesthetic outcome whether you use Medpor or Silicone. For some reason the top Euro surgeons tend to favour Medpor over Silicone and the results are just as crap.
I've heard stories from surgeons where Medpor had to be drilled off the skull because it was so deeply osseo-integrated.
The long term infection rate is about the same. Maybe a couple of percent lower for Medpor according to different studies.
Medpor implants are easier and cheaper for the surgeon to customise to the patient.
Silicone facial implants are actually hard. They won't be significantly compressed out of shape by facial musculature.
For people considering jaw angle implants I have an alternative which uses your own bone. I will be sharing my plan and the surgeon after I get my LF3.
Any feedbacks about doig Fat Grafts in the tear through and cheekbones?
I had two options :
Medpor implants in the infra orbital rim and zygomatic bone==>6000 K EUR
Or
Fat Grafts in the tear through and cheekbones for 2000 K
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mehdreamer, fat grafts are reabsorbed into the skin overtime. There are plenty of studies done on this in male enhancement forums, but also butt injections, same principle applies here. Even Kim K SUPPOSEDLY has to undergo maintenance back there....
When performed using proper techniques of harvesting fat, treating the fat, and then injecting the fat, the fat that survives is permanent living fat. The techniques of Coleman, Lam, and Glasgold have been proven to stand the test of time. The percentage of fat transferred that survives varies from about 40 to 60% with these techniques.
The fat that is there after 6 months will be with them for the rest of their lives. The key is choosing your fat transfer surgeon most carefully.