Is Hydroxyapatite Cement A Good Method for Paranasal Augmentation?

Q: Dr. Eppley, I’m a 26 year old woman who is a candidate for jaw surgery, but I’m unsure if I want to go through with it. I would be doing the surgery only for aesthetic reasons and am worried that the front of my face will look worse after the operation. I’m interested in paranasal augmentation because I have pronounced nasolabial folds due more to my bone structure and less to soft tissue sagging. However, I’d like for any method of paranasal augmentation I choose to not interfere with a future lefort if I change my mind. I was reading about hydroxyapatite cement, which, assuming a surgeon can cut through bone bonded with HA, seems like the perfect method except for maybe allergic reactions/soft tissue redness? I am not sure. Could you explain my options for the material used in paranasal augmentation (if any) and the pros and cons for each? Thank you for your time!

A: What you are really asking is what the easiest reversal method for paranasal augmentation should a LeFort I osteotomy be desired in the future. Silicone or ePTFE paranasal implants are the easiest to remove since there is no or limited tissue ingrowth into the material. While hydroxyapatite cement can be cut through with a saw it is not an easy material to remove due to the bone bonding that occurs to it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon