Removing Hardware

[GJ]

Hey guys, those of you who have had hardware removed (chin + both lower jaw plates), did you notice any issues?

Any negative effects in terms of looks or function from plate removal?

And does anyone know if plates in any way prevent relapse?

[Gadwins]

I had hardware removal in my chin and it had no negative effects in the long term, beside the usual discomfort after a surgery.

My surgeon said, that sometimes if you remove  plates, that afterward the muscle can slide better over your bone.

As far as I know, that all the relapse are due to tooth movements and not due to the bone movement. So if your orthodontic moved too much your teeth, then your teeth will more likely move back.

[GJ]

I had hardware removal in my chin and it had no negative effects in the long term, beside the usual discomfort after a surgery.

My surgeon said, that sometimes if you remove  plates, that afterward the muscle can slide better over your bone.

As far as I know, that all the relapse are due to tooth movements and not due to the bone movement. So if your orthodontic moved too much your teeth, then your teeth will more likely move back.

Thanks. Why did you have yours removed? Did you notice any improvement after?

[Gadwins]

It was necessary, because it was made of steel and not titan.

It is difficult to say if there is any improvent, because it's still worse than before the surgery.

[Lestat]

It was necessary, because it was made of steel and not titan.

It is difficult to say if there is any improvent, because it's still worse than before the surgery.

Whats wrong with steel?

[Gadwins]

just europe I think, that's what I found out. It was in local anesthesia so I didn't care much.

[varbrah]

Whats wrong with steel?

Probably biocompatibility concerns.

Hey guys, those of you who have had hardware removed (chin + both lower jaw plates), did you notice any issues?

Any negative effects in terms of looks or function from plate removal?

And does anyone know if plates in any way prevent relapse?

Haven't had plate removal but everything I've read seems to suggest it's fine to do so after 3-6 months or so, and shouldn't play into relapse risk. Shouldn't have an aesthetic affect unless you happen have some low grade inflammation from biocompatibility issues (unlikely with titanium).

Alfaro suggests 3 months after surgery, up to about a year or so since the plates will osseointegrate and be tougher to remove.

https://www.institutomaxilofacial.com/en/2020/03/12/should-plates-be-removed-after-orthognathic-surgery/

[kavan]

Plates can be removed after the healed bone cements things into place. Like any foreign material, if there's ever an infection later down the line, the anti-biotics won't be able to get to it. Also, harder to remove-due to bony overgrowth- if there is an infection and they stay in too long. As to materials, titanium is the more bio-compatible (over stainless steel) but also more costly. But still, since removal of plates is suggested after the bone is all healed (for the above stated reason/s) , that applies equally to both materials. So, since both materials can be removed within same/similar time frame, it doesn't matter if the plate is titanium or stainless steel. However, if a metal material actually needs to STAY in the face/body for a lifetime (which these plates don't), then titanium is the preferred material.

[ChinaBoy420]

Plates can be removed after the healed bone cements things into place. Like any foreign material, if there's ever an infection later down the line, the anti-biotics won't be able to get to it. Also, harder to remove-due to bony overgrowth- if there is an infection and they stay in too long. As to materials, titanium is the more bio-compatible (over stainless steel) but also more costly. But still, since removal of plates is suggested after the bone is all healed (for the above stated reason/s) , that applies equally to both materials. So, since both materials can be removed within same/similar time frame, it doesn't matter if the plate is titanium or stainless steel. However, if a metal material actually needs to STAY in the face/body for a lifetime (which these plates don't), then titanium is the preferred material.

Hey Kavan, I was to ask you this because you seem very knowlegable:

Do you think genio plates can be removed years later reliably for revisions? It would be a nightmare to be opened up again only to find out that the revision can't take place due to the plates being stuck.

[Salemare]

Hey Kavan, I was to ask you this because you seem very knowlegable:

Do you think genio plates can be removed years later reliably for revisions? It would be a nightmare to be opened up again only to find out that the revision can't take place due to the plates being stuck.

My understanding is there is a time frame for plate removal and have seen varying timescales suggested from 3-6 months to 1 year.

As mentioned by Kavan bony overgrowth can take place and if significant can make it very problematic to remove. I have had some European surgeons advise they dont do plate removal, however in Germany plate removal is now common place. Whether this was driven by patients wanting to avoid long term foreign body exposure or consensus amongst the medical community I dont know, but awareness of foreign body issues has grown signficantly in recent years for all kind of surgeries, involing metal or plastic.

You can also do a blood test to specifically see if you have any allergenic response to orthopaedic implant materials both for dental implants or plates. There are studies showing immune responses to titanium in some people so its an ongoing thing.

[GJ]

I had genio plates removed 9 years after the fact if anyone needs info on this in the future.

[ChinaBoy420]

I had genio plates removed 9 years after the fact if anyone needs info on this in the future.

Thank you so much for the update, I have a few questions:

1. Was the plate covered by a thick layer of bone?
2. If yes, how did the surgeon remove it? Was the any special techniques involved?
3. Did your surgeon say if plates that are years old can be removed with a decent success rate or is it a hit or miss?
4. Which surgeon did you go to if you don't mind?

[GJ]

Thank you so much for the update, I have a few questions:

1. Was the plate covered by a thick layer of bone?
2. If yes, how did the surgeon remove it? Was the any special techniques involved?
3. Did your surgeon say if plates that are years old can be removed with a decent success rate or is it a hit or miss?
4. Which surgeon did you go to if you don't mind?

No I don't think it was covered by bone...the surgeon made the smallest possible incision to get it out. He felt they could be removed and didn't mention anything about it being hit and miss. I'll PM you the surgeon.

The thing is, my lip position slightly changed after and feels tighter. I think added scar tissue, etc could be an issue. It's never good to cut the mentalis a second time (some do it more) and you run the risk of that muscle developing problems.