Q: Dr. Eppley, I am interested in getting a Peri-Pyriform Implant. As shown in my X-rays, I had Lefort1 osteotomy last year. I also had cheekbone reduction, mandibular reduction, and chin augmentation back before that. I am planning to remove the titanium screws before I get the Peri-Pyriform Implant. I do not know if that is necessary and I would love to hear your professional opinion regarding removing the titanium screws. I am also interested in getting cheekbone implant. I found a surgeon in Asia who places a Medpor implant below the lower eyelid area (the dark circle area, rather than the actual cheekbone area which is located below the outer eye corners) to give the patient a more convex midface and a more youthful look. I am wondering if we could discuss the possibility of getting the same implant along with the Peri-Pyriform Implant during our virtual consultation. Thank you very much for your time and consideration. I look forward to speaking with you soon.
A: In answer to your questions about the Peri-Pyriform implant::
1) It is not necessary to do a separate maxillary plate and screw removal if you do not want to. I can do that at the time of the implant placement.
2) The subcheek and peri-pyriform aperture implants can be done all in one procedure with the same surgical access.
Dr. Barry Eppley