Q: Dr. Eppley, In looking for jawline implants for total jawline enhancement do you think a good combined solution for chin and jaw is the Medpor Matrix system, or do the chin and jaw implants separately? I currently have some hyaluronic acid directly on my jaw angle and line because I did not know about such implants until recently, so I think I should remove that with “Hylase” before determining implant sizes.
My final questions to understand the size and shape of the implants and surgery would be:
a) JAW: The horizontal width of the RZ mandibular angle implants is 11mm (or 7mm respectively) at the LOWEST point of the implant and diminishing gradually to the top – like a triangle, correct? And as you mentioned the VERTICAL DROP is ALWAYS 10 mm regardless of the horizontal width of 3, 7, or 11mm? (which can be shaved down I guess if necessary?)
b) CHIN: With respect to a chin augmentation: If, just theoretically, I am satisfied with the length (anterior projection) of my chin length but NOT with the lateral horizontal width and shape (which I want to be SQUARE and 5 cm ranging from one corner of the mouth to the other) – are there available or can you shave down an medpor RZ extended chin implant so that there is NO or only 1-2 mm anterior projection but the same lateral and inferior projection as the medium sized RZ Ext Square chin implant? So practically speaking a customized RZ Square chin implant augmenting only laterally the side parts of the chin (like an implant without or only a 1-2 mm middle part9). An implant which makes the chin look more square and broader, which augments the lateral parts of the chin. (hope I expressed myself properly)
A: If I have to use off-the shelf implants, I generally stay away from Medpor because they are hard to put in, never fit very well to the bone, hard to stabilize to the bone and very hard to revise if that ever needs to be done. (of which the risk is about 25% of that need) I have used them a lot and the more I use them the less I like them. None of their purported benefits are true, other than soft tissue adheres to the implants making them a near nightmare to ever revise. But I will still use them when patients insist and some patients, like you, have an affinity for it.
When it comes to total jawline augmentation with Medpor, I would use a three-piece chin and jaw angle approach and not the Matrix system. The Matrix system is extremely hard to put in and virtually impossible to ever remove or revise due to the features of the material as previously described. Since the chin implant is put in as a two-piece implant with a male-female connector, it is easy to make a square implant but how far or close the two pieces are put together. It is, in essence, and adjustable width chin implant. When in doubt about jaw angle widths with the RZ style, it is always better to go with the biggest size as it can also be reduced during surgery. (but you can’t add to it)
Dr. Barry Eppley