Can Hydroxyapatite Bone Paste and Medpor Pieces Be Removed From My Chin and Jaw Angles?
Q: Dr. Eppley, Several years ago I had a sliding genioplasty and my jaw augmented with hydroxyapatite paste. I was unhappy with both as I still lacked horizontal and vertical chin projection and the HA paste on the jaw area was uneven. I tried to have it removed later but he was unable to remove the HA as he said it had integrated too much with my bone and tissue and was at risk of damaging nerves etc if removed. Instead he added pieces of Medpor under my chin to increase height and also placed Medpor pieces either side of my chin to fill gaps left from the genioplasty.
My question is, as someone who is more familiar with HA paste would you be able to remove the HA and Medpor and replace it all with a custom wraparound jaw implant?
A: Between the HA paste and the Medpor pieces added to your jawline the situation has become very difficult for successful efforts at complete removal of both. Quite frankly, on the surface, it is not very appealing surgery with increased risks of marginal mandibular facial nerve branch injury due to the location of the Medpor pieces. Removal of HA on the jaw angles is more of an issue with access, not a risk of any nerve injuries. When HA paste gets jammed back onto the jaw angles that is a convenient placement technique but not a removal one.
A more qualified opinion, however, would require a 3D CT scan of your lower jaw to really see what the internal bone structure now looks like.
Dr. Barry Eppley