Which Is Better For Total Midface Augmentation…Implant or Osteotomy?
Q: Dr. Eppley, I am interested on total midface augmentation due to very assymmetric and retruded face. I am very interested to use PEEK custom implant. However many surgeons recommend me to avoid implant because according to them such implants will erode or resorb my facial bone over time.
Is there any risk of bone resorption due to implant on the face or does such implant changes my facial bone structure over time?
BY THE WAY, ON YOUR OPINION IS IT POSSIBLE TO AUGMENT TOTAL MIDFACE BY OSTEOTOMY STARTING FROM FRONT ZYGOMA , MALAR, INFRAORBITAL SO TOTAL FACE AND POSSIBLY BONE GRAFTS USING AND IS IT POSSIBLE TO HAVE A GOOD SYMMETRY THIS WAY.
Thank you on your efforts for an answer.
A: In answer to your questions:
1) The potential issue of facial implants and bone resorption has been around for a long time and carries with it numerous misconceptions. While all facial implants, regardless of the material composition, induce some expected imprinting on the bone this should not be construed as active resorption or an issue of any clinical relevance.
2) No form of an osteotomy/bone grafting can replicate the assured smooth preplanned shape of a custom midface implant. The only role for osteotomies in aesthetic midface augmentation is in the patient who does not want an implant AND can accept the irregularities/stepoffs and other aesthetic contour issues that will arise from the much more imprecise nature of osteotomies in this facial area.
Dr. Barry Eppley