I’ve suffered for five years with large custom mandible medpor implants causing acute pain. There is evidence that the angle implants are impinging the posterior bellies of my digastrics, applying pressure to the hyoid bone and creating frequent choking sensations. The anterior bellies of the digastrics are also spasmatic and tightly slope from the chin to Adam’s apple. It’s hard to find a surgeon willing to remove them, but one did propose dissecting the digastrics. Is there a better way?
Option For Medpor Implant Removal 5 Years Post-Op? (photo)
Doctor Answers 2
Removal of Custom Medpor Mandible Implants
I have placed many jaw angle and jawline lengthening implants that go way below the inferior border of the mandible and have never seen impinging on the digastric muscles or the hyoid bone. While I have no doubt that you have the symptoms that you described, it is hard to imagine that there is direct connection between the implant and these structures. It is more likely soft tissue displacement and pressure, not direct bonding to these structures. That issue aside, I see no reason why they can not be removed regardless of their medpor composition. This material is more sticky to the surrounding soft tissues than silicone but it is far from impossible to remove. i have removed many medpor implants and, while requiring more surgical effort, can be successfulluy done. Your more significant aesthetic issue is what will happen to the expanded and stretched soft tissue and skin. There will likely be sagging afterwards.
Facial Implant Discomfort
Your photographs show a very nice cosmetic improvement after 5 years. Your symptoms are understandable given the fact the angle implant tends to wrap under the interior border of the mandible. A thorough examination and a CT scan would be helpful in appreciating the implants' relationship to your digastric muscle and hyoid bone.
After 5 years, the implant often has considerable ingrowth of tissue which could make for a difficult removal. One benefit of this ingrowth is that it lends itself to partial implant removal by stabilizing the portion of the implant you wish to leave behind.
Removing the lip of the implant that protrudes beneath the mandible should improve your symptoms while preserving to some degree your cosmetic result. Some sagging and recurrence of the initial problem may result.
Good luck and keep in touch.