THE BEST IMPLANT MATERIAL THAT YOUVE NEVER HEARD OF (or you might have idk)

[idont]

I think you answered your own question.

elaborate?
the porous properties allow for soft tissue integration

Although your bones dont grow into the implant your soft tissue grows into the actual implant because its fibrous. This makes it suitable for to withstand the physiologic load of masticatory and facial mimetic forces.

^^^^^^
thats why its good

 

[idont]

Check this out

https://www.journalofsurgicalresearch.com/article/S0022-4804(11)00757-8/abstract

just read the first paragraph and ill read it the rest after and come back to you but

"Mesh propensity to induce such adverse effects is likely related to the prosthetic's material, weight, and/or pore size."

so this is probably why it isnt the case for this type of polyester woven mesh

 

[Firstname.Lastname]

elaborate?
the porous properties allow for soft tissue integration

If that were an objective they would just use
hydroxyapatite and everyone would still ignore the dumb mesh.

 

[idont]

If that were an objective they would just use
hydroxyapatite and everyone would still ignore the dumb mesh.

no im not saying thats the objective im just counterarguing how youre saying its a bad thing

bone integration is generally better

 

[Firstname.Lastname]

no im not saying thats the objective im just counterarguing how youre saying its a bad thing

bone integration is generally better

I mean if you’re asking why no one uses it, they don’t use it because it integrates. PS do not think that’s a good thing. You might but they don’t which is why they don’t use it.

 

[idont]

I mean if you’re asking why no one uses it, they don’t use it because it integrates. PS do not think that’s a good thing. You might but they don’t which is why they don’t use it.

integration like this is generally considered bad because its almost impossible to reverse but

if theres no complications its great

 

[Firstname.Lastname]

integration like this is generally considered bad because its almost impossible to reverse but

if theres no complications its great

It’s not great if you don’t like it, or aesthetic taste change over time. If you really want it to integrate hydroxyapatite is just better if it’s replicating boney structures. You can get an implant made in it, and I’d think you could find a PS you could black pill into doing it. It’s not that crazy it just not consistent with their thinking for their practice on most people.

 

[idont]

It’s not great if you don’t like it, or aesthetic taste change over time. If you really want it to integrate hydroxyapatite is just if it’s replicating boney structures. You can get an implant made in it, and I’d think you could find a PS you could black pill into doing it. It’s not that crazy it just not consistent with their thinking for their practice on most people.

yeah ur right

if you are afraid of needing a revision this isnt the material for you

however this still shows the potential in woven polyester fiber materials for implants

the only con i see here is lack of reversibility

 

[bossman]

First, a quote from Dr. Eppley

The development of any surgical technique first begins with awareness followed by acceptance which then leads to common use.

This is what he said about infraorbital saddles many, many years ago. Even now, it is not commonly used - the most common user is the giant autist, Giant Implants.

The best methods or technology do not automatically become the standard practice in any field, especially surgery. Today, prefabricated silicon is still the default (and has been since 1953), despite the risk of bone resorption, capsule formation, migration etc, and despite the better alternatives out there, such as custom PEEK.

Most surgeons would rather not risk things by switching from what they are already experienced with - and this is what they end up passing on to the next generation. So even if this is the ultimate implant material, good luck getting a surgeon who will do it. With every material comes specific nuances with placement and soft tissue integration. So it will take a 5-10 years to establish the best practices for it.

But let's assume you're a billionaire who could push research efforts with the top maxillofacial surgeons in the world to start working with this material.

From the literature you refer to, it seems that Mersilene offers natural feel, tissue integration, low migration and low infection risk. Bear in mind that the Gross et. al. paper is a review of cases performed by a single surgeon. It seems exceedingly likely (as I will go on to explain) that the skill of this surgeon played a greater role in this than the material itself.

If you were to look purely at Yaremchuk's Medpor cases, or Eppley's Silicone cases, they too would have extremely low infection rates, low migration, low erosion etc. This is because these are skilled and experienced surgeons who have mastered the technique of working with their material of choice. However, we know that there are many, many surgeons who have caused very shit experiences for their patients with this material.

Oliver et al. published a meta-analysis in 2019 that pooled 17 studies combining 2100 patients and found that Mersilene's infection rate of 3.38% was the highest among all materials.

Furthermore, from what I can tell there is no published clinical series for Mersilene in jaw angle, mandibular body or infraorbital augmentation. One material won't work in every part of the face. Chin implants are easy and any material could be used under a skilled surgeon. My personal opinion is that PEEK is ideal in the jaw and silicon in the infraorbital region.

Dr Taban warns that porous implants in the eye area have a higher risk of eyelid scarring and eyelid malposition which makes it more unsuitable in this region. Porous implants in general are just extremely hard to get out, and you're always better off with a material that you can remove. As such, I would only be optimistic about this material for chin augmentation, potentially jaw augmentation in theory.

A 2023 review by Liao et al. concluded that there are "no statistically significant differences" between implant materials when it comes to extrusion, revision or removal rates, but Mersilene had insufficient data. So in reality the literature does not make any conclusion about this material - chances are it's the same as every other material: 95% reliant on the surgeon and their technique.

The TLDR takeaway is, the material is fairly irrelevant in the hands of a good surgeon. Meta-analyses on various methods and techniques are entirely irrelevant, as you want to go to a surgeon who has himself perfected a specific technique. That technique might not be reflected well in the literature if other surgeons tend to cause botches this way. Take custom plates for example, where the literature would suggest it is highly effective and offers significant advantages over bending plates in the OR. However, all of the greats like Raffaini and Arnett actively dislike custom plates and do things their way - because they have mastered it to create the perfect aesthetic result.

I know what it is like to become attached to an idea intellectually and I've been guilty of doing it many times. But my advice would be to snap out of it, and be realistic about what's on offer, because there is absolutely no problem with it. You are better off spending your time researching good implant surgeons, as this forum does not know a single one.

 

[Firstname.Lastname]

yeah ur right

if you are afraid of needing a revision this isnt the material for you

however this still shows the potential in woven polyester fiber materials for implants

the only con i see here is lack of reversibility

Yeah and that’s why they don’t use materials that integrate. It’s problematic for practice management. I think specifically the mesh would have issues with things like fibrosis or encapsulation due it it really simi-integrating vs hydroxyapatite which just turns into your own bone ie can’t be encapsulated due to it being on the bone nor would it likely cause fibrosis since it very afixed as is everything that integrates into it. Unlike soft tissue.

 

[idont]

First, a quote from Dr. Eppley



This is what he said about infraorbital saddles many, many years ago. Even now, it is not commonly used - the most common user is the giant autist, Giant Implants.

The best methods or technology do not automatically become the standard practice in any field, especially surgery. Today, prefabricated silicon is still the default (and has been since 1953), despite the risk of bone resorption, capsule formation, migration etc, and despite the better alternatives out there, such as custom PEEK.

Most surgeons would rather not risk things by switching what they are already experienced with - and this is what they end up passing on to the next generation. So even if this is the ultimate implant material, good luck getting a surgeon who will do it. With every material comes specific nuances with placement and soft tissue integration. So it will take a 5-10 years to establish the best practices for it.

But let's assume you're a billionaire who could push research efforts with the top maxillofacial surgeons in the world to start working with this material.

From the literature you refer to, it seems that Mersilene offers natural feel, tissue integration low migration and low infection risk. Bear in mind that the Gross et. al. paper is a review of cases performed by a single surgeon. It seems exceedingly likely (as I will go on to explain) that the skill of this surgeon played a greater role in this than the material itself.

If you were to look purely at Yaremchuk's Medpor cases, or Eppley's Silicone cases, they too would have extremely low infection rates, low migration, low erosion etc. This is because these are skilled and experienced surgeons who have mastered the technique of working with their material of choice. However, we know that there are many, many surgeons who have caused very shit experiences for their patients with this material.

Oliver et al. published a meta-analysis in 2019 that pooled 17 studies combining 2100 patients and found that Mersilene's infection rate of 3.38% was the highest among all materials.

Furthermore, from what I can tell there is no published clinical series for Mersilene in jaw angle, mandibular body or infraorbital augmentation. One material won't work in every part of the face. Chin implants are easy and any material could be used under a skilled surgeon. My personal opinion is that PEEK is ideal in the jaw and silicon in the infraorbital region.

Dr Taban warns that porous implants in the eye area have a higher risk of eyelid scarring and eyelid malposition which makes it more unsuitable in this region. Porous implants in general are just extremely hard to get out, and you're always better off with a material that you can remove. As such, I would only be optimistic about this material for chin augmentation, potentially jaw augmentation in theory.

A 2023 review by Liao et al. concluded that there are "no statistically significant differences" between implant materials when it comes to extrusion, revision or removal rates, but Mersilene had insufficient data. So in reality the literature does not make any conclusion about this material - chances are it's the same as every other material: 95% reliant on the surgeon and their technique.

The TLDR takeaway is, the material is fairly irrelevant in the hands of a good surgeon. Meta-analyses on various methods and techniques are entirely irrelevant, as you want to go to a surgeon who has himself perfected a specific technique. That technique might not be reflected well in the literature if other surgeons tend to cause botches this way. Take custom plates for example, where the literature would suggest it is highly effective and offers significant advantages over bending plates in the OR. However, all of the greats like Raffaini and Arnett actively dislike custom plates and do things their way - because they have mastered it to create the perfect aesthetic result.

I know what it is like to become attached to an idea intellectually and I've been guilty of doing it many times. But my advice would be to snap out of it, and be realistic about what's on offer, because there is absolutely no problem with it. You are better off spending your time researching good implant surgeons, as this forum does not know a single one.

thanks so much bra i read everything

so from what ive learned this polyester porous materials like these have potential its just its not a one size fits all like better options

if they ever find out how to fix lack of reversibility i reckon it has potential

what material is best for supraorbitals (specifically)

 

[idont]

Yeah and that’s why they don’t use materials that integrate. It’s problematic for practice management. I think specifically the mesh would have issues with things like fibrosis or encapsulation due it it really simi-integrating vs hydroxyapatite which just turns into your own bone ie can’t be encapsulated due to it being on the bone nor would it likely cause fibrosis since it very afixed as is everything that integrates into it. Unlike soft tissue.

yeah ur right

ive gathered from this thread that it has potential but it most likely wont be of any use for craniofacial implants in the foreseeable future

 

[bossman]

thanks so much bra i read everything

so from what ive learned this polyester porous materials like these have potential its just its not a one size fits all like better options

if they ever find out how to fix lack of reversibility i reckon it has potential

what material is best for supraorbitals (specifically)

you can’t fix lack of reversibility it just needs an experienced surgeon

technically medpor is in the same boat but there are some surgeons who can remove it with ease

i am not too sure about supras but then again i’d only go to giant for them and he does peek so that should be the answer

 

[Firstname.Lastname]

Yeah it could be used for something else maybe but it’s not a great option for plastic surgery. Personally I think PEEK implants are best, but they cost alot. Theoretically PEKK would be better but no one in PS is making these, bc supply is limited and it’s not really approved yet.

 

[idont]

you can’t fix lack of reversibility it just needs an experienced surgeon

technically medpor is in the same boat but there are some surgeons who can remove it with ease

i am not too sure about supras but then again i’d only go to giant for them and he does peek so that should be the answer

yeah so its less about the material sometimes and more about the surgeon

also about giant I havent researched but im pretty sure his waiting list is long asf

i guess peek would be the answer then

also are u planning to become a maxfax surgeon? or something in this field

 

[idont]

Yeah it could be used for something else maybe but it’s not a great option for plastic surgery. Personally I think PEEK implants are best, but they cost alot. Theoretically PEKK would be better but no one in PS is making these, bc supply is limited and it’s not really approved yet.

ill look into them

they could be an option by the time im looking into it

 

[Firstname.Lastname]

ill look into them

they could be an option by the time im looking into it

There basically just PEEK implants but better virtually every way, less infection rate, stronger.

 

[idont]

There basically just PEEK implants but better initially every way, less infection rate, stronger.

i see okay

idk how i havent came across it

i just started a book about implants so it might be in there but idk

 

[Firstname.Lastname]

i see okay

idk how i havent came across it

i just started a book about implants so it might be in there but idk

Bruh cuz literally no one’s making them. I think they are sometimes used in skull reconstruction for sever trauma but that’s it.

 

[idont]

Bruh cuz literally no one’s making them. I think they are sometimes used in skull reconstruction for sever trauma but that’s it.

yeah ik but its still in relation to implants

if its undergoing trials i would of likely heard of them but i didnt somehow

thanks for the info tho

 

[brainregeneration]

People say titanium attracts waves causing headaches, Im way more inclined towards peek implants

Tufano speaks of this