Sharing some Hydroxyapatite paste knowledge I've acquired from different consultations

[kingofkings]

I once believed that hydroxyapatite paste/granules had the potential to be a superior alternative to facial implants, specifically on the cheekbone area. However, after consulting with several surgeons, I learned the following information:

- Accurate placement of HA on the cheekbones is challenging. Partly due to the difficulty of access and partly due to the material itself
- There is a risk that HA can settle unevenly, appearing lumpy. This is a problem both aesthetically and also in terms of your health, as it could lead to irritation of the soft tissue (redness, swelling or even infection)
- Surgeons often apply HA with a lack of precision, essentially "slapping it on and hoping for the best." Thus, it is not suitable for detailed shaping.
- It's also not ideal for large alterations. It's not like with filler where you can get away with putting a ton of it on the destination site.
- Removing HA is difficult, as it integrates rapidly and almost permanently into the bone. Surgeons may struggle to completely remove it, often having to scrape it off.
- Bear in mind there are different HA pastes out there with new ones having better qualities than the older ones
- What it is decent for, is as a second-best substitute when autologous bone isn't available and you want to bridge an osteotomy step-off or notch. It's also a tiny bit better on the jaw compared to the cheekbones, as access there is easier

Hopefully this helps anyone who searches for information on this topic

 

[perpetuallytired]

I once believed that hydroxyapatite paste/granules had the potential to be a superior alternative to facial implants, specifically on the cheekbone area. However, after consulting with several surgeons, I learned the following information:

- Accurate placement of HA on the cheekbones is challenging. Partly due to the difficulty of access and partly due to the material itself
- There is a risk that HA can settle unevenly, appearing lumpy. This is a problem both aesthetically and also in terms of your health, as it could lead to irritation of the soft tissue (redness, swelling or even infection)
- Surgeons often apply HA with a lack of precision, essentially "slapping it on and hoping for the best." Thus, it is not suitable for detailed shaping.
- It's also not ideal for large alterations. It's not like with filler where you can get away with putting a ton of it on the destination site.
- Removing HA is difficult, as it integrates rapidly and almost permanently into the bone. Surgeons may struggle to completely remove it, often having to scrape it off.
- Bear in mind there are different HA pastes out there with new ones having better qualities than the older ones
- What it is decent for, is as a second-best substitute when autologous bone isn't available and you want to bridge an osteotomy step-off or notch. It's also a tiny bit better on the jaw compared to the cheekbones, as access there is easier

Hopefully this helps anyone who searches for information on this topic

Interesting.

 

[normie_joe]

I once believed that hydroxyapatite paste/granules had the potential to be a superior alternative to facial implants, specifically on the cheekbone area. However, after consulting with several surgeons, I learned the following information:

- Accurate placement of HA on the cheekbones is challenging. Partly due to the difficulty of access and partly due to the material itself
- There is a risk that HA can settle unevenly, appearing lumpy. This is a problem both aesthetically and also in terms of your health, as it could lead to irritation of the soft tissue (redness, swelling or even infection)
- Surgeons often apply HA with a lack of precision, essentially "slapping it on and hoping for the best." Thus, it is not suitable for detailed shaping.
- It's also not ideal for large alterations. It's not like with filler where you can get away with putting a ton of it on the destination site.
- Removing HA is difficult, as it integrates rapidly and almost permanently into the bone. Surgeons may struggle to completely remove it, often having to scrape it off.
- Bear in mind there are different HA pastes out there with new ones having better qualities than the older ones
- What it is decent for, is as a second-best substitute when autologous bone isn't available and you want to bridge an osteotomy step-off or notch. It's also a tiny bit better on the jaw compared to the cheekbones, as access there is easier

Hopefully this helps anyone who searches for information on this topic

Pretty sure Gunson uses this in his patients.

 

[kingofkings]

Pretty sure Gunson uses this in his patients.

Yes, it's widely used by most max fac surgeons as back in the day it was the de facto standard for bone grafting. That's it's primary intended purpose and does it's job well for this.

In terms of cheek enhancement, he offers something a bit different. Rather than slapping on the HA during surgery, he builds some kind of facial implant with HA mixed with collagen prior to the surgery. This is a much better approach than applying the HA on the fly (I've consulted with some top surgeons and they all said they could only offer to lump it on during surgery). But you also need to be mindful of a big downside when you try to put a large volume of it on a single spot - once it's implanted inside your face it takes 1 to 2 months to "go fully hard". So it's kind of a gamble how it will ultimately turn out as it will change shape to some degree until it's fully hard.

Personally , I'd rather go for a conventional implant as it can be 3d printed to the exact spec in advance, doesn't change shape and can be easily removed if it's silicone. But if I had to use HA I would opt for someone using Gunson's approach.

If anyone is interested this is a result from Gunson's insta I found just now.

Before:

After:

Not a fan of the outcome myself

 

[wereq]

Eppley said the same thing about HA bone cement paste. Its mostly used by him to shape and augment the skull, but he rather do custom silicone implants over HA paste because its tricky and hard to shape.

 

[normie_joe]

I once believed that hydroxyapatite paste/granules had the potential to be a superior alternative to facial implants, specifically on the cheekbone area. However, after consulting with several surgeons, I learned the following information:

- Accurate placement of HA on the cheekbones is challenging. Partly due to the difficulty of access and partly due to the material itself
- There is a risk that HA can settle unevenly, appearing lumpy. This is a problem both aesthetically and also in terms of your health, as it could lead to irritation of the soft tissue (redness, swelling or even infection)
- Surgeons often apply HA with a lack of precision, essentially "slapping it on and hoping for the best." Thus, it is not suitable for detailed shaping.
- It's also not ideal for large alterations. It's not like with filler where you can get away with putting a ton of it on the destination site.
- Removing HA is difficult, as it integrates rapidly and almost permanently into the bone. Surgeons may struggle to completely remove it, often having to scrape it off.
- Bear in mind there are different HA pastes out there with new ones having better qualities than the older ones
- What it is decent for, is as a second-best substitute when autologous bone isn't available and you want to bridge an osteotomy step-off or notch. It's also a tiny bit better on the jaw compared to the cheekbones, as access there is easier

Hopefully this helps anyone who searches for information on this topic

A surgeon I consulted said you are better off going with implants as HA paste is near impossible to remove if you don't like the result.

 

[longjohnmong]

Before:
View attachment 3090443

After:
View attachment 3090445

Not a fan of the outcome myself

This result is utter shit. Imagine paying $100k for Gunson because you think they're the best in the world, only for them to slap some paste wherever, with zero understanding of facial aesthetics

this is another Gunson one:

you can see how low they put it. like, i can feel on my face where the topmost screw is on the lefort hardware on the cheek, and the fact that they put the paste under that is insane. it's down by his gums. the crazy part is the result isn't even that bad.