How Soon After Orthognathic Surgery Can I Get Custom Infraorbital-Malar Implants?

Q: Dr. Eppley, I’m very interested in infraorbital-malar implants, as well as potentially paranasal implants to improve my deficient midface after I have a LeFort I osteotomy and BSSO that’is scheduled later this year. So I’m writing this as I have two questions for you! First one is how long after should I wait to have a consultation about these implants due to residual swelling and the bones healing etc. In terms of getting the actual implant i’ve seen online that waiting 6 months after is enough although I will ask my surgeon specifically on that. But what I mean is to have the initial consult and get the process started in deciding on the implants and design? My second question is how the process in determining the appropriate sizing of the implants to get my desired result works? As having mild midface hypoplasia I believe I’d need larger implants but don’t really understand how the planning goes for it. Like I know what I would want my end result to look like and would be able to create that look in a picture with a sort of filter, but seeing pics of scans of the implant on my skull and measurements etc. is quite confusing to me on what it would actually look like on my face. I would hate for it to be too big, or too small and have to revise, which is why I’m curious how you go about that.

Thank you very much and hope to hear back soon!

A:In answer to your custom midface implant questions:

  1. You need to begin the process at any time since the implant design process takes 3 to 4 months and getting a surgery date may taken even longer.
  2. The implant design process requires a lot of learned experience to understand what shape and measurements on an implant design mean to an external facial change. This is a translation that no patient can really make with any accuracy…although some try. (and often fail with their chosen measurements) This is why patients should largely leave those design decisions up to me. Implant designing is not an exact science and is more of an art form.

Dr. Barry Eppley

World-Renowned Plastic Surgeon