Peri-Pyriform Implant

Q: Dr. Eppley, I understand that you are the inventor of the Brink Peri-Pyriform implant. I am writing you to inform you that this implant improved my speech and my life. I am American-born Chinese, and English is my native language. However, until I had the Peri-Pyriform implant put in, I always had a significant amount of difficulty speaking fluently and clearly.

All of my life, people have often told me that they could not hear, or make out, what I was saying, or that it seemed like I spoke with an “Asian American accent.” Several years ago, I noticed that words containing “ch”, “sh”, “j”, “zh”, “n”, and “r” sounds were especially difficult for me to articulate. I also began to notice that many other Asian people, both native and non-native English speakers, also exhibited these speech characteristics to varying degrees. Furthermore, as I am sure you already know, Asians typically have shorter head lengths than do people of other races.

This led me to a theory: In Asians whose head lengths are particularly short, separation between the upper lip and the premaxilla impairs articulation of the speech sounds “ch”, “sh”, “j”, “zh”, “n”, and “r”, and this, in turn, impairs significantly the articulation of words and sentences containing these sounds in English and French, and possibly in other phonetically similar languages.

Shortly after coming up with this theory, I had premaxillary augmentation surgery using the Peri-Pyriform implant. Immediately after the surgery, my articulation of those sounds was improved, as well as my clarity in speaking.I had always been very quiet. Now that I can speak more fluently and clearly, I am less shy about speaking, and I have a much happier disposition. Hopefully, others like me will also be able to benefit from the Peri-Pyriform implant.

A: Thank you for your relaying your experience with implant augmentation of the pyriform aperture region. I have to confess that I did not do the original design of the implant, that credit goes to Dr. Brink as indicated in the implant product’s name/description. I do have a lot of experience with this facial implant, however, and most of that is in Asian patients for the facial shape reasons you have described.

Of all the potential benefits of a Peri-Pyriform implant, speech improvement is not one I have ever heard of or could envision occurring. Your anatomic explanation/theory sounds perfectly plausible however as it can cause greater upper lip projection, particularly at the nasolabial area. That may improve upper lip contact with the lower lip which may help in articulation with certain sounds.

Regardless of how it may have helped, you are living proof that it indeed has. I could not be more happier for you that such a simple facial procedure could have been so helpful.

Thanks again for taking the time to share your most fascinating facial implant experience,

Dr. Barry Eppley

Indianapolis, Indiana