Q: Dr. Eppley, I am interested midface implants. Two years ago, I had a Lefort surgery to advance my upper jaw. I plan on getting a rhinoplasty at a future date. At the present time, I am only interested in getting facial implants to augment the tear trough/cheek areas and the midface. Specifically, I am interested in knowing if I am a candidate for a premaxillary implant and if premaxillary implants are often used on patients who have already had orthognathic surgery. Thank you for your time.
A: In my experience it is not uncommon at all to have patients who have undergone a LeFort osteotomy to subsequently want midface augmentation with implants. This is because, as you have experienced, the Lefort I osteotomy essentially moves the teeth and the lower nasal base forward (or upward) but leaves the rest of the midface ‘behind’.
The key question about midface augmentation is whether standard preformed midface implants will suffice or whether a complete custom midface implant is needed. Standard midface implants include cheek, tear trough and paranasal/premaxillary implants which augment the respective names areas. A more complete total midface implant is designed to create a total augmentation from the infraorbital rim/cheeks down to the lower level of the pyriform aperture/maxilla.
Dr. Barry Eppley