Medpor Facial Implant Removal and Replacement

Q: Dr. Eppley, I have had off the shelf Medpor chin and mandibular angle implants in for the last decade and desire a greater degree of augmentation and resolution of underlying asymmetries that could only be achieved with custom implants.

My two questions are; 1) can 3D CT modeling be done with the current implants in place, and 2) will removal and replacement of current Medpor implants really carry a large risk of disfigurement?

Thank you in advance for your reply.

A: In answer to your Medpor facial implant removal and replacement questions:

1) Your indwelling chin and jaw angle implants are not a problem for designing new custom implants as they are digitally removed to do so in the designing process. Having existing jaw implants in place does help in designing new implants as having a known effect guides what an improved effect should look like. 

2) Having removed and replaced many Medpor facial implants I am not certain where the concept of causing facial disfigurement emanates. Certainly their removal poses greater difficulties than if they were silicone implants, but their removal does not cause facial disfigurement/deformity that I have seen. Their removal often causes greater temporary swelling due to the more extensive tissue dissection needed from the adherence of the soft tissues to the implant surface.

Dr. Barry Eppley

Indianapolis, Indiana