Jaw line implants - which material - which doctor?

[PeterPan91]

Hi,

i am from europe. I am very happy with the way I look. But one thing has bothered me for a long time: my jaw line

Already had a genioplasty and liposuction on the neck. Still, I don't have a real jawline. My jawbone is just too weak in width.

Don't have a receding chin. All the aesthetic surgeons have also confirmed that I do not need a jaw operation. Angled jaw implants were recommended to me.

1.) Dr. Sailer uses Medpor implants for the jaw angle. However, I have a bad feeling about Medpor. Medpor grows together with the tissue over time and can then no longer be removed properly. So if there are any problems, removal is extremely difficult.

Dr. Sailer believes, however, that angular jaw implants do not lead to resorbation of the bones. That would only be the case with chin implants.

2.) Dr. Defrancq uses PEEK implants. It's a lot cheaper, but Dr. Sailer seems to have more experience.

Peek has the advantage that the material can be easily removed.

3.) No one in Europe offers silicone implants for the mandibular angle.

What's the best solution? Which material has advantages?

Thanks

 

[Deleted member 4430]

this isnt a looksmaxing forum

 

[Deleted member 6723]

Bumo

 

[Deleted member 8988]

Top kek at this thread

 

[CommanderCope]

 

[MansNotHot]

I dunno hope someone else responds tbh

 

[PeterPan91]

Don't understand the problem with the question? Isn't this about aesthetic issues, etc.?

 

[ayfhdsfsdlgj]

Andrey started an absolute war against silicon implants in general, including at jaw angle implants (look at 2:16)

Silicone in face is evil for hundreds of years, silicone facial implants have been used, and for another hundred we will have to deal with the consequences.
Why are such outdated technologies still used today? Good question.
Cheapness, simplicity, availability. It is not customary to talk about the long-term consequences for the patient's health ... And the changes that arise are called implant shrinkage or bone adaptation.
@amborovikov
@khrustaleva
@dr.chkadua.plastic
@arthur_rybakin
@drjoeniamtu
@prof_maurice_mommaerts
@konstantin_a_matveev
@dr.guryanov
@simonasgrybauskas
@dreppley
@federico_hernandez_alfaro
@face_surgery_parma

jfl at him calling out Eppley btw

(Also: https://looksmax.org/threads/eppley...ing-my-story.207583/#lg=thread-207583&slide=2)

As for the silicone vs medpor argument:

Facial Implants: Controversies and Criticism. A Comprehensive Review of the Current Literature - PubMed

Medpor implantation is more common than silicone. Complication rates are low with the use of both materials. Patient follow-up is deficient and has not improved in the past 20 years, raising questions on the reliability of complication rates.

pubmed.ncbi.nlm.nih.gov

Plastic Surgery Case Study - Removal of Medpor Chin Implant and Replacement with Two-Piece Square Silicone Chin Implant - Explore Plastic Surgery

Medpor chin imlpants can be successfully removed and replaced if desired.

exploreplasticsurgery.com

tl;dr silicon shifts away more easily buy is easier to remove.

 

[PeterPan91]

Thank you for the helpful answer

Is there a study anywhere on how often Medpor, PEEK or silicone implants need to be removed?

I once read that Medpor implants can cause problems many years after the operation (infections, etc.). Do you then have to remove the implants or is antibiotics enough, for example?

 

[justanothergymcell]

Based andrieschev calling out Eppley and tagging his ig account.

But we need more information about who performed the procedures and how long the implants had been in the two patients shown.

 

[RealSurgerymax]

Angled jaw implants were recommended to me.

Let me start by saying the satisfaction rate for jaw angle implants is not as high as it could be so I hope you find the read worthwhile.

1.) Dr. Sailer uses Medpor implants for the jaw angle. However, I have a bad feeling about Medpor. Medpor grows together with the tissue over time and can then no longer be removed properly. So if there are any problems, removal is extremely difficult.
This is the extreme disadvantage of the implant material with no real proven advantage in aesthetic applications. Medpor Facial Implants still leave a small imprint on the underlying bone just like silicone implants. "Tissue ingrowth" is marketed to be an advantage but really is not. I think this is confused or taken for obscure idea that bone is growing into it which for the most part is not true. This is scar tissue growing inside the implant where as a scar tissue capsule usually grow around an implent. Perhaps the fact it is white is what gives people the initial appeal but make no mistake this material is not any more similar to bone than silicone. Polyethylene is the same kind of Plastic Grocery Bags and milk jugs are made from.

In reconstructive applications the vascularization of Poruous Polyethylene has utility though - you can even grow skin grafts on top of it.

The disadvatage of a vasularized porous polyethylene implant is that it can literally become injuried and bleed. When fractured or broken up during removal the implants themselves can bleed profusely. Unlike PEEK or Silicone PPE can fracture and be permanetly compressed.

And then like you say, is very difficult to remove.

Further there is not off the shelf jaw angle implant that truly appropriate for 2 reasons:
1. Unlike chin implants which fit and bend well over a simle curvilinear shape, the inner contour of the prefabricated jaw angle implant (whether Silicone or Medpor) will almost never fit to the native jaw angle well. This is evidnced by numerous malpositioned implants seen postoperatively and the high regret & removal rate.
2. The outer contour of pre-fabricated (that is off-the-shelf) jaw angle implants is frankly not aesthetic. They will almost never actually give the chiseled, sharp, dominant jawline the patient got them for. They will result in a bloated look most of the time and I can say that having farmiliarity with the designs of implantechs and medpors full line of jaw angle implants. The least offending of both of these, if you must try an off the shelf jaw angle implant are the RZ Jaw Angle Implant by Medpor and the Widening Jaw Angle Implant by Implantech.

I feel strongly all jaw angle implants should be patient specific for a higher satisfaction rate. The currect satisfaction rate is frankly unnacceptable and why many plastic surgeons do not offer Jaw Angle implants at all. Very favorable results can be achieved with thoughtful custom design, while I would say more than half of off-the-shelf jaw angle implant patients are dissatisfied.

Dr. Sailer believes, however, that angular jaw implants do not lead to resorbation of the bones. That would only be the case with chin implants.

Gonial Angles are resistant to bone resorption. They also have a noted, well-documented regnerative power. Bone growing over or on top of a jaw angle implant is more common than bone erosion of a jaw angle implant (seen in Medpor, Silicone, and PEEK)

2.) Dr. Defrancq uses PEEK implants. It's a lot cheaper, but Dr. Sailer seems to have more experience.

Peek has the advantage that the material can be easily removed.

PEEK is in my opinion the best implant material for the jaw angles and brow ridge. PEEK implants are always custom designed. The Rigidity of the material helps to place it exactly as planned.

It's interesting that you say its cheaper because PEEK is an extremely expensive biomaterial and material in general. Much more than Polyethelene and silicone.

3.) No one in Europe offers silicone implants for the mandibular angle.

What's the best solution? Which material has advantages?

 

[PeterPan91]

Angled jaw implants were recommended to me.

Let me start by saying the satisfaction rate for jaw angle implants is not as high as it could be so I hope you find the read worthwhile.

1.) Dr. Sailer uses Medpor implants for the jaw angle. However, I have a bad feeling about Medpor. Medpor grows together with the tissue over time and can then no longer be removed properly. So if there are any problems, removal is extremely difficult.
This is the extreme disadvantage of the implant material with no real proven advantage in aesthetic applications. Medpor Facial Implants still leave a small imprint on the underlying bone just like silicone implants. "Tissue ingrowth" is marketed to be an advantage but really is not. I think this is confused or taken for obscure idea that bone is growing into it which for the most part is not true. This is scar tissue growing inside the implant where as a scar tissue capsule usually grow around an implent. Perhaps the fact it is white is what gives people the initial appeal but make no mistake this material is not any more similar to bone than silicone. Polyethylene is the same kind of Plastic Grocery Bags and milk jugs are made from.

In reconstructive applications the vascularization of Poruous Polyethylene has utility though - you can even grow skin grafts on top of it.

The disadvatage of a vasularized porous polyethylene implant is that it can literally become injuried and bleed. When fractured or broken up during removal the implants themselves can bleed profusely. Unlike PEEK or Silicone PPE can fracture and be permanetly compressed.

And then like you say, is very difficult to remove.

Further there is not off the shelf jaw angle implant that truly appropriate for 2 reasons:
1. Unlike chin implants which fit and bend well over a simle curvilinear shape, the inner contour of the prefabricated jaw angle implant (whether Silicone or Medpor) will almost never fit to the native jaw angle well. This is evidnced by numerous malpositioned implants seen postoperatively and the high regret & removal rate.
2. The outer contour of pre-fabricated (that is off-the-shelf) jaw angle implants is frankly not aesthetic. They will almost never actually give the chiseled, sharp, dominant jawline the patient got them for. They will result in a bloated look most of the time and I can say that having farmiliarity with the designs of implantechs and medpors full line of jaw angle implants. The least offending of both of these, if you must try an off the shelf jaw angle implant are the RZ Jaw Angle Implant by Medpor and the Widening Jaw Angle Implant by Implantech.

I feel strongly all jaw angle implants should be patient specific for a higher satisfaction rate. The currect satisfaction rate is frankly unnacceptable and why many plastic surgeons do not offer Jaw Angle implants at all. Very favorable results can be achieved with thoughtful custom design, while I would say more than half of off-the-shelf jaw angle implant patients are dissatisfied.

Dr. Sailer believes, however, that angular jaw implants do not lead to resorbation of the bones. That would only be the case with chin implants.

Gonial Angles are resistant to bone resorption. They also have a noted, well-documented regnerative power. Bone growing over or on top of a jaw angle implant is more common than bone erosion of a jaw angle implant (seen in Medpor, Silicone, and PEEK)

2.) Dr. Defrancq uses PEEK implants. It's a lot cheaper, but Dr. Sailer seems to have more experience.

Peek has the advantage that the material can be easily removed.

PEEK is in my opinion the best implant material for the jaw angles and brow ridge. PEEK implants are always custom designed. The Rigidity of the material helps to place it exactly as planned.

It's interesting that you say its cheaper because PEEK is an extremely expensive biomaterial and material in general. Much more than Polyethelene and silicone.

3.) No one in Europe offers silicone implants for the mandibular angle.

What's the best solution? Which material has advantages?

Thank you for the very valuable answer. Helped me well!

Dr. Eppley recommends submentoplasty. Are there good doctors for this in Europe? Somehow I can't find anyone in Germany.

He rather advised against jaw implants. He said that could be a useful addition. But jaw implants often don't look nice on people who have fat in the chin area.

 

[RealSurgerymax]

Thank you for the very valuable answer. Helped me well!

Dr. Eppley recommends submentoplasty. Are there good doctors for this in Europe? Somehow I can't find anyone in Germany.

He rather advised against jaw implants. He said that could be a useful addition. But jaw implants often don't look nice on people who have fat in the chin area.

Submentoplasty is usually a combination of submental liposuction with platysmaplasty. It shouldn’t be hard to find someone who is experienced in that. Anyone who advertises many good facelift Before and afters is familiar with these techniques.

 

[curryslayerordeath]

@RealSurgerymax how are jaw angle implants fitted next to the masseter muscles and could usage of those muscles in chewing lead to a step off forming later? iirc some psl user (i think his username was Sal) had some complications related to this