Hydroxyapatite Granules for Facial Augmentation
Q: Dr. Eppley, I’m very sorry to take up more of your time, but I just had a couple questions about my surgery path and I wanted a second opinion. By a local surgeon, I was referred to a plastic surgeon who uses hydroxyapatite granules for facial augmentation. I was wondering, what are your thoughts on using this method to add the missing width to my chin. I’m not looking to project it further outwards, but as I had said earlier, just to increase the horizontal width.What problems or benefits are there? Or would a reverse t-osteotomy technique be best.
A: I have had to revise a lot of hydroxyapatite granule augmentations of the face. They often end up irregular and lumpy. Hydroxyapatite granules for facial augmentation is an old method from the 1980s, which does have some clinical successes in small areas of facial bone augmentations. But it is a fairly uncontrolled pushing of hydroxyapatite granules blindly into a subperiosteal tissue pocket and hoping it will end up perfectly smooth. Sometimes it does and sometimes it doesn’t.
There is nothing wrong with using an implant material to augment the width the chin bone. But I would favor a more structured or rigid material that could be shaped and fitted without the risk of distortion.
And then there is, as you have mentioned, the chin widening osteotomy method as well. But I would still favor an implant material as it is more predictable.
Dr. Barry Eppley