It's great that the internet provides us the ability to discuss technique like this on public forums. However, remember that none of us are plastic or oral surgeons so we can never really get it. Clinical experience is impossible to replace. We have our own advantages too of course. One concept I want to drill down is the importance of following evidence based medicine. You do not want to be Guinea Pigs. Biology is very complex and most of what humans do, we f**k things up. Some general rules about medicine:
- If something is really good, it won't be long before practice spreads to others
- If others aren't interested, there's probably a reason and it's probably not evident to us. I can assure you that it's not because others are incompetent or unaware. We know this from private discussions where we can see what surgeons say to other people when they ask about it.
- For the most part, there's a common body of knowledge and all surgeons have access to the same body of knowledge. Not all are interested in learning or trying. Each has their own unique personality and treatment goals.
- Surgeons are generally unaware of their outcomes. Patients often seek help elsewhere after problems and are afraid to speak up except to other patients.
One point I want to make since it was brought up here, it's true these HA augmentations integrate with underlying bone. The plus is also the down, you can't remove them if they become problematic. I've asked around enough and familiar with some of the problems. At this point I would say there's nothing I know of to definitely exclude them as a treatment option, everything has been fairly minor with them so it looks promising. It is, however, not a routine procedure at this point, still an experimental technique. Another option to consider is demineralized bone paste, which does actually turn into bone albeit over a much longer time period.
