Why Could Premaxillary-Paranasal Implants Potentially Affect One’s Smile?
Q: Dr. Eppley, I was considering a paranasal and premaxillary implant but came across a lot of negative reception regarding how the implants “ruin” your smile.
1) What kind of ruining would they be referring to? Is it the increased philtrum distance and flattening of the top lip? If so, could this be mitigated via lip lift?
2) Some say that they can see something protruding when they smile, is it because their implant is too large? How many mm would you say is the maximum for an implant?
A: Nasal base implant augmentation has a history in which many of these implants were placed through the nose into the subcutaneous tissues. This has the potential to place a physical block when trying to smile. A more contemporary implant location is in the subperiosteal location through an intraoral approach which lowers this negative smiling effect significantly. Besides placement location the size of the implant also can have an effect if it is too large. While each patient is unique I wold not add more than 6mms of augmentation in the nasal base area….and even less so across the anterior nasal spine area.
Dr. Barry Eppley
World-Renowned Plastic Surgeon