Advanta ePTFE Facial Implants in Cosmetic Facial Surgery

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Presentation transcript:

Advanta ePTFE Facial Implants in Cosmetic Facial Surgery Joseph Niamtu, DMD Journal of Oral and Maxillofacial Surgery Volume 64, Issue 3, Pages 543-549 (March 2006) DOI: 10.1016/j.joms.2005.11.022 Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 1 Hardened and contracted lip ePTFE implants removed from a patient at 12 months. These smaller implants were originally placed to augment the “white roll” of the upper lip. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 2 The dual porosity configuration provides the main differences of other ePTFE implants. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 3 The top picture shows an implant measured on the patient’s upper lip in repose. The lower picture is the same implant shown with the patient’s mouth wide open. In this posture the implant would be too short. The point is to measure prospective implant length with the mouth wide open. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 4 A, Round 5 mm implant. B, Tendon passer inserted through the middle of the upper lip from the entrance incision to the exit incision. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 5 The labial artery of the lower lip (arrows) is shown in this cadaver dissection. The artery traverses the upper lip in the posterior 1.3 of the lip at the level of the vermilion-cutaneous junction and also corresponds to the incisal edges of the lower incisors. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 6 A, Implant grasped by the inserted tendon passer. B, ePTFE implant pulled through the lip tunnel with several millimeters of implant protruding at the exit incision. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 7 The correct plane for implant placement on the facial tissues (non lip) is subdermal. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 8 A, Tendon passer traversing just medial to the nasolabial fold and grasping the implant at the exit incision. B, Implant in place before trimming the tails. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 9 A passing awl is placed in the subdermal plane to pull an ePTFE implant back through the incision via an attached suture. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 10 This patient is shown 8 weeks after placement of Advanta implants in the upper and lower lip. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 11 An oblique view of the same patient shown in Figure 10. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 12 This patient is shown 2 months after Advanta implant placement in the upper and lower lips. Note increased pout and volume of both lips. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 13 This image shows the same patient as pictured in Figure 12. Smiling and normal oral function is not impeded with this soft and pliable implant. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 14 This patient is shown 2 months after Advanta implants to both nasolabial folds with concomitant laser resurfacing. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

FIGURE 15 A, Visible and palpable tail of an implant placed too superficially (outlined with surgical marker) on the left nasolabial fold. B, Protruding implant tail after incision. C, Trimmed implant tail resting over the sutured incision to show the amount of implant tail trimmed. Joseph Niamtu. Advanta Implants in Cosmetic Facial Surgery. J Oral Maxillofac Surg 2006. Journal of Oral and Maxillofacial Surgery 2006 64, 543-549DOI: (10.1016/j.joms.2005.11.022) Copyright © 2006 American Association of Oral and Maxillofacial Surgeons Terms and Conditions