Medpor Facial Implant Removals

Q: Dr. Eppley, I am interested in Medpor facial implant removals. I had a Medpor chin implant and angle jaw implant done ten years ago. Is there a way to have the implants removed or shaved down to be smaller? I would prefer removing. The jaw implants has two screws and the chin implant one screw. I have read that Medpor is challenging to remove because of potential sagging but suspension can be done. I wear a beard and don’t know if this could be hidden behind beard. Both were done through the mouth not externally. Thank you.

A: Medpor facial implant removals are challenging because of the significant tissue adherence that they have. But they can be successfully removed and I have removed many of them. An important issue with any chin implant removal, particularly when done from inside the mouth, is the risk of chin or lower lip sag thereafter. Even with good muscle suspension this is still a potential issue because what the implant has done is create an overall tissue expansion effect. When you remove the support (chin implant) there is a relative soft tissue excess that may not be overcome by an form of tissue suspension. This depends to some degree on what size the original implant is. But knowing this is a Medpor chin implant, by definition, this is a larger implant with long wings on it. So this issue is probably very relevant to you. This why ideally such implant removals should be supplemented with some residual chin augmentation whether it is a much smaller implant or a small sliding genioplasty subtotal replacement.

Such issues are less pertinent to jaw angle implant removals as they are not anterior projecting structures.

It is best to think of total implant removals, not in situ implant reshaping. This is a recipe for facial asymmetries and implant irregularities.

Dr. Barry Eppley

Indianapolis, Indiana