Can Medpor Facial Implants Be Trimmed In Place?

Q: Dr. Eppley, I considered getting custom silicone jawline implant but in the end I got the medpor implants in my home country. I got RZ mandibular angle 11mm, and RZ extended square chin implant (5mm) The op took place 7 mounths ago. The implants were fixated with titanium screws. Choose of the implants was meant do get so caled “wraparound” or “matrix” effect.

The operation went succesful exept one thing – propably due to the natural assymetry of the lower part of my face, or wrong placement done by the surgeon – I endend up with crooked chin, more specific, the left side of my lower face is somehow more portruded than the right side, it’s seems too rounded, which causes the left jaw implant look so out of place, so unnatural, like a result or swelling, while the right side creates a natural looking straight line. As I said I don’t know the exact cause of this result, the implant either shifted or it’s the left wing of an Implant, which causes too much projection, but I pressume the reason behind this is the lack of implant customization before inserting it, and it made my face look even more assymetrical than before. I’m writing this because you have had many experiences with medpor implant removal, and I wanted to ask a few questions about possible correction:

1) Can a medpor implant be safely trimmed through the intraoral/skin incision or does it have to be removed, trimmed and inserted again? Is it a saw or scalpel to be used to shave it down?

2) – If my case requires implant removal/replacement – Because of long size of the chin implant wings, my chin implant lays partially over mandibular implants, as the wings reach the jaw angles. Are these three implants became commecected due to the tissue ingrowth? And If they did, could future chin implant correction or removal be dangerous to jaw angle implants?

3) After one side of an implant is shaved down, weather 2 or 3mm, or completely, could it somehow cause the middle and right side to shift, due to lack of balance?

4) If chirurgical intervention were too risky, could it be treated with HA dermal fillers to achieve facial symmetry?

Best regards and thank you in advance for your answers

A: When using standard implants to create a total jawline augmentation effect the question is not whether there will be asymmetry, as there always will be, but how significant will it be and how will it needed to be treated.

In answer to your questions:

1) Medpor implants will need to be removed, modified and reinserted.

2) The jaw angle implant can be removed despite the wing of the chin implant overlying it.

3) No.

4) Injectable fillers can always be used to help with the asymmetry of any paired set of facial implants.

Dr. Barry Eppley

World-Renowned Plastic Surgeon