Q: Dr. Eppley, I know that the Hydroxyapatite in the  world using only a few professional surgeons.  But I know that it is difficult to remove if something goes wrong. PMMA bone cements is more cheap than hydroxyapatite but how much it’s better ?  I do not like silicone implants. Their many uses silicone implants since it is easy for surgery but I do not feel that it will give a nice aesthetic effect. And now I am confused choosing between hydroxyapatite or PMMA bone cements. 

Could you explain please what is better to use and advantages and disadvantages between . I still do not really understand A: You have several misconceptions about the materials. Hydroxyapatite is fairly easy to remove just like PMMA and silicone implants. In the brow bone area PMMA produces a better aesthetic shape and is easier to place in that area to create the effect. Regardless of the material used, the aesthetic result is based on its shape not the material composition. Quite frankly the best way to brow bone augmentation is a 3D silicone implant made from a CT scan. It is best because the shape and dimensions of the brow bone augmentation is designed and controlled BEFORE surgery. The surgeon’s job then is just to place the implant correctly. All other materials, such as hydroxyapatite and PMMA, require intraoperative shaping and that is far less precise.

Dr. Barry Eppley
Indianapolis, Indiana