Q: Dr. Eppley, I am interested in custom paranasal implants. I would like custom designs because I do not think that the standard implants will provide enough forward projection. I think I need about 7 to 8mms forward projection while the standard paranasal implants only provide about 5mms of projection at the anterior nasal spine level.
A: While custom paranasal implants can be made, I would opt for what I call semi-custom paranasal implants. These are actually custom paranasal implants made for other patients. But when used for someone else we call them ‘semi-custom’. I have found that the size and fit of most of the custom paranasal implants will fit just about anybody. (and coincidentally they all have been made for Asian patients who are seeking the same aesthetic changes you are) Semi-custom facial implants cost less than custom facial implants. Well-fitting paranasal implants can’t really or become displaced…but I still put a very small screw into each side just to be sure.
A custom paranasal implant can produce a facial effect that is very similar to that of a LeFort I osteotomy. While it does not move the teeth forward like a maxillary osteotomy can, its effect on the nasal base is very similar.
Dr. Barry Eppley