Can A Premaxillary Implant Be Removed?

Q:  Dear Dr. Eppley, I had a submaxillary Gore-Tex implant placed at the same time as a rhinoplasty over fifteen years ago. It was done to elevate the area below my nose to improve the shape of the angle between my lip and nose. Later it was determined by an oral surgeon that I needed upper jaw surgery but that would be extremely difficult as this implant sticks to the bone and therefore he would not operate on me. I can live with all of the above; however, this implant is annoying as on the right side it continues to dig down into my right upper gum area. I have been told that this type of implant can be very difficult to remove and that it would be best to just leave it alone. What is your opinion on getting it removed?

A:  To clarify the issues in regards to your Gore-tex facial implant, here is what I think:

1) To be exact, it is a premaxillary implant not a submaxillary implant. Because it is Gore-Tex and placed during a rhinoplasty, it was inserted through a nostril base incision initially. It was done to open up the nasolabial angle.

2) Gore-tex does not adhere to the bone and is the one of the least ‘sticky’ implants to remove. It is smooth and the body places a capsule around it.

3) Because it was placed long ago, it is likely a multi-stranded Gore-tex implant rather than a solid one-piece implant composition. This makes it a little more difficult to remove but certainly far from impossible.

4) Your premaxillary implant can be removed through an incision inside the mouth as that is just as close as going through a nasal base incision.

Dr. Barry Eppley

Indianapolis, Indiana