Are HA Injections For Genioplasty Notching Safe?

Q: Dr. Eppley, I am writing to you because you are an expert with osseous genioplasty and maybe you can help me. I had a sliding genioplasty 7 months ago. But after the surgery one little piece of bone was missing at the site of the osteotomy. Also I had asymmetry. So the result was ok except for the noticeable notching effect and asymmetry. So yesterday I had HA injection to make it look better and the results are great. But now I am wondering can this HA interact with the titanium plates I have? Maybe it can be dangerous?  Also, can this HA interact with the bony remodeling which might not be completely complete? What do you think? Thank you very much for your help.

A: Notching along the inferior border of the mandible at the back end of a genioplasty is very common, particularly when a significant horizontal advancement is done. The injection of HA into the notch areas is a perfect treatment for this secondary genioplasty deformity. It has no negative interaction with the indwelling titanium plates and screws. Filling in the bone defects will not change any residual bone remodeling and may, in fact, help the process.

Dr. Barry Eppley

Indianapolis, Indiana