Q: Dr. Eppley, I had Medpor chin and paranasal implants placed close to 3 weeks ago. The implants were both placed intraorally.However, I still have issues with stiffness and a little difficulty with lip closure. Can I just check whether these issues are normal at this stage of recovery, or is it something I should be worried about? The stiffness in movement is one that concerns me the most, as it does affect my speech a little. Lastly, if this isn’t typical, would removal of these implants be possible?
A: What you are experiencing for these types of facial implants is extremely typical. My experience and what I counsel my patients on before surgery is that to expect the following recovery as it relates to swelling, function and aesthetics…50% by three weeks, 75% by 6 weeks and 100% by three months. Thus you are being way premature to even consider implant removal as you have not gotten yet to see what the final result will be. Your perception of what you thought your recovery would be is undoubtably much less than that and this accounts for your concern at this early recovery point. Patients understandably do not appreciate that this is, in essence, very similar to bone surgery even though it is done for aesthetic purposes.
Dr. Barry Eppley
Q: Dr. Eppley, I had extensive surgery involving a large number of facial implants and forehead augmentation and back of the head skull reshaping two weeks ago. While I knew there would be a lot of facial swelling, I think much of the swelling is gone now and I am concerned about some of the areas that have been augmented, particularly the forehead and cheeks. Both areas seem too big or prominent although each day they seem a little different. At what time would you consider revisional surgery?
A: With any single facial implant and certainly with multiple implants, you are far from having all swelling gone or are looking at the final result. I set the minimum time of three months before I would pass judgment on the result. This is not only to let all facial swelling resolve but it also takes time to adjust to one’s new look. This is a hard psychological time for patients to go through but it is very important to not rush to judgment on a ‘moving target’. It is good to remember over the next few months, these skull and facial shapes will change, go up and down, one day look good and the next day uncertain, until the final evolution appears months later. This is a lot to endure and watch evolve. How you feel today might be different next week. It also doesn’t help, and is not unfortunately therapeutic, when all you have to see and talk to about these issues is yourself. That is a good way to lose perspective not only on facial surgery in particular but on life in general. One of my tasks as a plastic surgeon for my patients is to not let them lose perspective and make premature decisions and judgments. I can never tell anyone what they should like, but I can guide them as when their surgical results are finalized.
Dr. Barry Eppley