Hydroxyapatite Facial Augmentation
Q: Dr. Eppley, I had a genioplasty and jaw augmentation a little over a year ago. The jaw augmentation was performed using hydroxyapatite paste along the jawline and the results are pretty asymmetric and too bulky for my face. The surgeon who performed the procedure is in Belgium and if possible I’d rather have it corrected by someone closer to home. I’m hoping my jaw can be shaved down or contoured to better fit my face and correct the asymmetry. I really hope you can help me. Thanks and kind regards.
A: While hydroxyapatite granules are the most biocompatible material for only bone augmentation, they unfortunately do a poor job of establishing a smooth outer facial contour. I have revised numerous patients who have undergone hydroxyapatite facial augmentation by hydroxyapatite (HA) granules/paste and they all have the same lumpy irregular bone contours. The concept of injectable HA bone augmentations is appealing but it is prone to a high incidence of aesthetic contours problems just like you have. The good news is that these augmentation irregularities can be smoothed or modified to a better contour just like any bony outcropping. Interestingly many HA augmentations will have a fair amount of bone ingrowth into and around them which actually makes their modifications easier than if the granules were just on top of the bone by themselves. It would be very helpful to have a preoperative 3D CT scan to a clear idea as to the exact location of the HA augmentations and their size compared to where the excessive bulk/asymmetries are seen on the outside of the face.
Dr. Barry Eppley