Oral and Maxillofacial Surgery Expert Forum
Augmentation of Jaw/Chin with Hydroxyapatite
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Augmentation of Jaw/Chin with Hydroxyapatite

Two years ago I had augmentation of my jaw/chin done by a  plastic surgeon using Hydroxyapatite. The goal was to widen my jaw by adding volume at the start of the jawline. Additionally, volume was going to be added to my chin to widen it. Well, instead of adding volume right the start of my jaw, the surgeon chose to add a large blob of Hydroxyapatite midway long my jaw and then blend it forward towards the chin. The result looked ridiculous as the volume was added in the jowl area and then angled forward to create a 'spearhead' chin. Rather than having a jawLINE, i ended up with a multi-angle jaw and a narrow, pointy chin.

I recently had the same plastic surgeon attempt to correct this previous mistake. Unfortunately he's only half done the job, and that half became infected. The Hydroxyapatite that he added this time around (in the correct position) all flowed out of the oral incision 10 days after the surgery when it became infected. I've totally lost faith in the ability of this plastic surgeon and need to find someone who is skilled in the surgical application of Hydroxy to fix this mess. I have only found one other plastic surgeon in the world who uses hydroxyapatite and he won't use it on the jawline. I'm not referring to the injectable type of Hydroxy, but rather the granules that are mixed with blood and surgically applied in a cavity between the periosteum and the bone.

Do Maxillofacial surgeons use the same Hydroxyapatite for bone reconstruction? Do you think a Maxillofacial surgeon could remove Hydroxy already placed along my jawline and do the job that the plastic surgeon was supposed to do? If so, can you recommend a stand out surgeon in Australia or the USA whom I could contact to discuss my situation?
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Sorry for the delay.

I am not familiar with nor have I ever used HA for cosmetic augmentation.  I do not believe this is standard practice in the United States.  The problem with HA is that it is difficult to remove the particles from the tissues.

I would definitely seek the advice of a Board Certified Oral and Maxillofacial Surgeon who does cosmetic facial surgery or a Board Certified Plastic Surgeon.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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I thought the reason I PAID to post my question on this website was so that it WOULD be answered by a medical professional?
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373693_tn?1324489102
Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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