Q: Dr. Eppley, I had a PMMA forehead implant placed a few years back, but I’m looking for more augmentation still. I would like to go with the custom silicone implant route, but I have a couple of questions. Is it possible to remove the PMMA implant and design the silicone implant from scratch? I’ve heard some surgeons say that bone cement is impossible to remove, much like Medpor. Can the incisions used for the previous implant be used again for the new silicone implant? I would like to avoid additional scarring if possible.
A: Thank you for your inquiry. In answer tho your questions, a PMMA forehead implant can be removed quote easily. So the surgeons who have said it is difficult or impossible to remove must have no experience with it. A silicone custom forehead implant is designed off of a 3D CT scan. During the deign process the PMMA implant is digitally removed so only the bone is seen. Thus it is no problem to design a forehead implant with an existing PMMA implant in place. I will use the ghost image of the PMMA implant to design the new implant since it serves as a useful reference for how much more augmentation can be achieved. The identical scalp incision used to place the PMMA implant would be used for the new custom forehead implant so no new scarring would be created.
Dr. Barry Eppley