Will Changing My Paranasal Implants Give Me A Better Result?

Q: Dr. Eppley, I have a question related to my paranasal implants. from Korea. Five months ago I had this augmentation but now I am disappointed with the result. I start to have awkward smile and a much longer upper lip. But because I have a sunken nose base, I do need the augmentation. In short, I am planning to remove the paranasal implant and change to a new one. I am wondering if I want to have an improved result whether I need to do these procedures separately (6months or so after removing current implant then add a new one) or can I do these two procedures together in one single surgery. It would be much easier for me to have only one surgery. But I am really worried that if I do so (removing and changing the implants at one time), that the swelling during the surgery might affect the doctor’s aesthetic decision for the new implant. Besides I am also worried that if I have only one surgery, whether it is possible the new implant would be much more likely to change its position on my face in future. Do you have any suggestion for my problem?

A:  To provide a very specific answer, it would be helpful to know what type of paranasal implants these were, what was their shape and how were they placed. (through the mouth and and on the bone around the pyriform apertures or placed through the nose in the soft tissue of the nasal base) One of the advantages of having existing implants in place is now you know the result they create. That provides valuable information as to how to change them for an improved result. The existing problems with your current paranasal implants could be their size, shape, and/or anatomic location. The change should be predictable before surgery, not during the procedure. Therefore, there should be no problem removing and replacing them during the same procedure. I see no advantage to a staged procedure. In fact, I would find that actually counterproductive. Knowing what didn’t work well is a good guide to improving it.

Dr. Barry Eppley

Indianapolis, Indiana