Do you know if Medpor can be custom 3D modeled/fitted? Or are all medpor implants 'off the shelf'
It can be customized and also be shaved during surgery or after surgery if needed for revision. All implants can be custom made I think.
Implants can be tricky because it's about millimeters, sometimes 1 millimeter makes a difference. It's difficult to calculate the right amount of millimeters, especially because most surgeons don't use simulation with soft tissue on face. The best surgeons know it's about 1 or 1.5 millimeter horizontally or vertically, etc. If a surgeon says 'one or two millimeters more or less doesn't matter' you better watch out. Facial harmony is very important.
There is this notion when it comes to jaw angles, wrap around or chinimplant, that more is better, which is, in most cases, not true. Doing less than needed though, sometimes doesn't give significant improvement. I know that yamarshuk takes time to design the implant, but i don't know how good he is technically. The design is crucial. The surgeon is able to shave parts of the implant during surgery, but this is not always ideal, and even if he thinks it's better to do it, he doesn't know if the client wants that. It's a very difficult procedure when it comes to creating the right aestethics, especially if your face is already harmonious or when you don't have the angular phenotype naturally. Technically, it's not that difficult from my understanding.
Preserving the ogee line is very important (the reason that manipulating the jaw and chin on photoshop looks good is because the shadows and ogee line are preserved, leaving the face 'lean' and not bloated like you see with some implants). One of the problems is, most jawangle implants go high up on the mandible, cause they need to be fixed, while you only need the angle in most cases. But when you look at the implant(designs), you see there is implant material at places where it's not needed. This is done to fix it and make it stable, but aestethically, something like 30-40 percent of the wrap around implant is aestehtically useless, I guess.
In the end, luck probably plays a big role as well (although all surgeons will say it's not about luck).
