Your Questions

Q: Dr. Eppley, I had Medpor jaw angle implants placed a year ago, but they did not provide sufficient lateral and vertical augmentation. I have been told that it would not be possible to replace the existing jaw angle implants due to Medpor’s tissue adherence, which is why I am thinking of getting a Medpor square chin implant with longer width to provide that augmentation.

That being said, I would very much prefer to get the Medpor jaw angle implants replaced, but I’m unsure if that’s possible. Do you think its removal would prove too difficult to be worth the risk? If not, could I replace it with another Medpor jaw angle implant at the same time?

A: If the proper jaw angle implant style is not used, the vertical elongation of the jaw angle area that many patients really need will not be achieved. While Medpor facial implants are harder to remove than silicone, it is not true that it is impossible to remove them. I have removed and replaced numerous Medpor chin and jaw angle implants. If you are still focused on using Medpor jaw angle implants then it would need to be the RZ style of either a 7 or 11mm width. Removal and replacement of jaw angle implants is done at the same time as that would be the most convenient and efficient way to do it.

Dr. Barry Eppley

Indianapolis, Indiana

Q:   Dear Dr. Eppley, I have some asymmetry on the right side of my face due to orthognathic surgery.  I consulted with a Craniofacial surgeon specialist to correct this deformity.  I also asked about getting implants on both sides because of my small mandible.  The surgical plan was to correct the asymmetry on the right side and put in jaw implants on both sides.   The same size jaw implants were used on both sides without correcting the asymmetry.  The drop down on these implants is too much for my face.  I have Medpor implants which were put in about a month ago.  I want to get these removed and just have the deformity corrected.   When is the best time to remove these implants?  Thank you and I looking forward to your reply.

A: The swelling after jaw angle implant surgery can be considerable and it takes longer than a month to really see the final results. At only a month after surgery, I am not sure you can be absolutely certain they are too vertically long. Ideally, one should wait a full 2 to 3 months to be certain you really want to reverse your initial efforts. However, if you are very certain at even this early postoperative time, then you should get the implants out as soon as possible. It is always easier to remove porous implants like Medpor sooner rather than later before extensive tissue ingrowth has occurred.

Dr. Barry Eppley

Indianapolis, Indiana