Is it true Medpor causes no bone loss while silicone implants do? Whatever the pros of silicone, bone loss is a serious tradeoff

There is no objective or scientific data to compare silicone versus porous polyethylene (Medpor, Omnipor, and other manufacturers) in the amount of bone erosion that occurs beneath facial implants. A study would have to performed whereby similar sized and located silicone and porous polyethylene implants would be placed in the same individual. For example, the right half of the chiin would be augmented with porous polyethylene and the left with silicone. Such a study has yet to be done.This question can only be answered with anecdotal data - one's clinical experience. Based on my extensive clinical experience, I am confident to report that bone loss does occur beneath porous polyethylene implants, but not routinely, and when it does, it is significantly less than that below silicone implants.

The finding of 'erosion', better termed passive adaptation, is most commonly seen with chin implants. It occurs in both silicone and Medpor chin implants. It does not occur in all patients and may occur irrespective of the implant size. This is a passive bone remodeling response to the implant due to the tight soft tissues of the chin. This is not an inflammatory erosive process. While a biologic reality it is not something one should be concerned about as it is self-limiting and causes no bone problems.

I have been using silastic " rubber silicone" for over 40 years, and, thousands of implants later, I have not had one case of erosion.Most of the so called erosions, I suspect, are xray artifacts that have no clinical significance, or had improper surgery.Its just that Medpor is a very hard substance while the silastic is softer, so it does not make sense that silastic is more likely to casue erosion. Silastic becomes encased in a pocket . Medor, gets tissue ingrowth, and is difficult to remove, should that ever be necessary.

For chins, there are features which vary amongst patients. There is a "muscle"/mentalis which has a variable thickness and density, varying thickness of the layers of the mandible in that area, different growth patterns whereby some people have inability to close their lips/ high angle, and different heights of the chin area etc etc. Typically all implants will resorb bone in the chin area ' depending opon the pressure by the mentalis. So Medpor is no different. Many surgeons will only do a sliding genioplasty for that reasoning as well as the fact that a genioplasty is better able to create a 3D contour.