Road to fixing recessed upper maxilla: paranasal implants and/or fillers.

[Deleted member 16380]

I was at a plastic surgeon consultation today, and he suggested I do pyriform fillers.
I never even suspected i had an upper maxilla recession, just felt that "something was off".

I know this injection exists, but a little bit scared to try it due to a higher chance of blindness that in usual filler manipulations like eyelids or chin, plus it is expensive (450 Euro per 1ml), so would not want to do any useless manipulations.

So, I am trying to understand, what exactly do we achieve with paranasal fillers and/or implants?

From my looksmax search, I found some scarce information, with some examples, that it can "kinda project the upper portion of maxilla".
Online search is not better. Results are scarce, and in most pictures, it is not even clear what happened.

One great result, exactly what I would benefit from (though i do not need so much projection, my recession is miniscule):

Female paranasal implant result

looksmax.org

So, who knows about these procedures? @Deusmaximus

Plz ping others who might now something about this, let's have brainstorming

 

[Deleted member 7725]

You sure your lower maxilla isn't recessed?

 

[incel194012940]

The paranasal region is where the nose starts. The top image has a projected paranasal and the bottom had a recessed one. Too much variation to nail an exact ratio, but you can see eyeball comparing the nose base to the philtrum and lips.
I wouldn't fuck with fillers, I would get an implant/bone graft if its a concavity. Too much risk of mitigation to the philtrum, stiffening the region, making it so your nose doesn't move when you smile.

Midfacial Soft-Tissue Changes after Paranasal Augmentation with Porous Polyethylene - PubMed

The aim of this study was to determine the effect of porous polyethylene in paranasal augmentation on the overlying soft tissue. Thirty-three patients underwent paranasal augmentation using 3-mm-thick porous polyethylene and mandibular setback, and 35 patients underwent mandibular setback only...

pubmed.ncbi.nlm.nih.gov

I think it was this study that showed that a paranasal implant has like 20% less soft tissue projection than the implant size. So standard size of 5mm implant would get ya 4.2mm or smth.

If it's just at the side of the nose, and maybe premaxillary (upper part of the philtrum) you can get the incisions inside your mouth, like in a lefort 1.

 

[Deleted member 16380]

You sure your lower maxilla isn't recessed?

Quite certain.

But of course, it depends what we call "recessed". I definitely do not have the forward growth of barrett, but my plastic surgeons never mentioned anything about my upper jaw.

And no bite issues since birth ofc, my upper jaw matches my lower jaw perfectly.

Black line is from glabella in Frankfurt plane.

 

[Deleted member 16380]

View attachment 1709813
The paranasal region is where the nose starts. The top image has a projected paranasal and the bottom had a recessed one. Too much variation to nail an exact ratio, but you can see eyeball comparing the nose base to the philtrum and lips.
I wouldn't fuck with fillers, I would get an implant/bone graft if its a concavity. Too much risk of mitigation to the philtrum, stiffening the region, making it so your nose doesn't move when you smile.

Midfacial Soft-Tissue Changes after Paranasal Augmentation with Porous Polyethylene - PubMed

The aim of this study was to determine the effect of porous polyethylene in paranasal augmentation on the overlying soft tissue. Thirty-three patients underwent paranasal augmentation using 3-mm-thick porous polyethylene and mandibular setback, and 35 patients underwent mandibular setback only...

pubmed.ncbi.nlm.nih.gov

I think it was this study that showed that a paranasal implant has like 20% less soft tissue projection than the implant size. So standard size of 5mm implant would get ya 4.2mm or smth.

If it's just at the side of the nose, and maybe premaxillary (upper part of the philtrum) you can get the incisions inside your mouth, like in a lefort 1.

I actually need rhino, which I probably do later. Maybe it makes sense to ask the surgeon to also install the paranasal implant, cause I also do not like the idea of fillers in this area.

I found that Implantech has these type of implants

Peri-Pyriform™ - Implantech

A premaxillary implant designed to augment the perialar area around the pyriform aperture. Adds anterior projection to the premaxilla and provides a platform for the nasal base.

www.implantech.com

But how do I know the size?
This is something that I wouldn't want to redo unlike fillers

 

[bogii]

I actually need rhino, which I probably do later. Maybe it makes sense to ask the surgeon to also install the paranasal implant, cause I also do not like the idea of fillers in this area.

I found that Implantech has these type of implants

Peri-Pyriform™ - Implantech

A premaxillary implant designed to augment the perialar area around the pyriform aperture. Adds anterior projection to the premaxilla and provides a platform for the nasal base.

www.implantech.com

But how do I know the size?
This is something that I wouldn't want to redo unlike fillers

is every surgeon able to place those implants in while doing rhino, or is this only done by a specialist?

it looks like mine lacks too

 

[Deleted member 16380]

is every surgeon able to place those implants in while doing rhino, or is this only done by a specialist?

it looks like mine lacks too

Good question.

Mine doesn't specialize in rhino, so even if he can insert this implant, he is useless, since no rhino.

And the best finnish rhino surgeon, idk... he has no mention of implants on his website

How to find a guy who does both

 

[incel194012940]

But how do I know the size?
This is something that I wouldn't want to redo unlike fillers

Quite certain.

But of course, it depends what we call "recessed". I definitely do not have the forward growth of barrett, but my plastic surgeons never mentioned anything about my upper jaw.

And no bite issues since birth ofc, my upper jaw matches my lower jaw perfectly.
View attachment 1709820View attachment 1709822
Black line is from glabella in Frankfurt plane.

tbh I would consider that a recessed positioning of the upper to lower lip and suggest a lefort.

But if you wanna go for the implants route, get a completely non lens distorted side profile image, with a ruler in it, and measure how many mm you need for the paranasal base to reach that black line. May be complications from doing it on that maxilla.

 

[Deleted member 16380]

tbh I would consider that a recessed positioning of the upper to lower lip and suggest a lefort.

Yep, but in my case this is "just the lip" like that. It often goes with recessed maxilla, but apparently not in my case. I just have a thin-ass upper lip

But even if it were a recessed maxilla which i doubt, I would not cut my jaw, since i do not like cutting my jaws anyways

But if you wanna go for the implants route, get a completely non lens distorted side profile image, with a ruler in it, and measure how many mm you need for the paranasal base to reach that black line. May be complications from doing it on that maxilla.

Will try this in gimp