Q: Dr. Eppley, it has been a while since I last spoke with you and I have been thinking more about the paranasal implants. In the photo morphs you sent me, we had adjusted the degree of projection to be a little bit less than the first morph sent a while back. In the current photo morph how much thickness of the implant would you estimate using? (<5 mm). The first picture is the morph of my face, the second an example of paranasal augmentation with cartilage I found in a paper, and the third is a patient review from a Korean plastic surgery site.
I have seen quite a few results from Korea on this procedure, but I feel that there is too much augmentation in these procedures, leading to an unnatural upper lip appearance. Before going for implants can an adequate saline injection or temporary filler give me a good simulation of how the implants might behave on my face?
If not, do you happen to know of any other publications or available data/photos on paranasal implant results?
Thank you for your time and advice.
A: When it comes to any form of facial augmentation, it is not an exact science. There is no way currently to know precisely what effect any degree of augmentation could create or how a patient will feel about the degree of change they have experienced. The only thing I know for sure about paranasal augmentation is that anything less than 3mms would be too small and anything bigger than 7 or 8mm would probably be considered too much. But how to pick an amount augmentation within this range is anyone’s guess.
Certainly injectable fillers are an accepted temporary approach for a paranasal implants augmentation trial. They do not have the same push as an implant and do not create the exact same look, but they are still reasonable to try. But I am not sure they really give a good ‘implant test’ response.
Dr. Barry Eppley