Eppley is amazing but I there is a problem with his preference for silicone as his implant material.

[Deleted member 399]

So I've been reviewing Eppley's work through his blog posts and Instagram posts. It seems that most of his work is done using silicone. When patients bring up suggestions of using other materials such as PEEK, titanium, and what not, he rebuffs them, saying that custom design would be too expensive for those materials. Now, no doubt what he's saying is true, but I can't help but think that he's not too comfortable using rigid materials such as PEEK.

Rigid materials require larger incisions, installation by small parts (implant is broken into different sub-parts and then fixated onto bone), and screw attachments. Rigid materials are also harder to remove compared to silicone. With silicone, its easier to slide it into the face with small incision, without any screws or attachments and can be easily removed if necessary. But the problem with silicone implants is rejection by the body as well as displacement. This is why I'm in favor of PEEK over silicone.

In Japan, they don't like the use of foreign materials and prefer to use calcium phosphate implants which integrates with the patient's bone and is converted into bone. The use of calcium phosphate and hydroxyapatite is the next frontier in implant material. Europeans are getting ready to use calcium phosphate in their patient specific implant designs. I've come across many such biotech companies who are planning to use calcium phosphate.

 

[CopingCel]

Imagine getting a shitty PEEK Jaw implant that is not visible at all and then having to redo it. It is way easier with silicone.

But I am highly interested in lower infecton rates, etc.Are there any trustworthy studiesregarding these bio materials?

 

[CarlSagan96]

Imagine getting a shitty PEEK Jaw implant that is not visible at all and then having to redo it. It is way easier with silicone.

But I am highly interested in lower infecton rates, etc.Are there any trustworthy studiesregarding these bio materials?

I see no difference between those two pics lol

 

[Deleted member 399]

Imagine getting a shitty PEEK Jaw implant that is not visible at all and then having to redo it. It is way easier with silicone.

But I am highly interested in lower infecton rates, etc.Are there any trustworthy studiesregarding these bio materials?

If the implant isn't giving you adequate projection, you should blame the design and not the material itself. Silicone if easier unril you get a chronic infection and you need your implant removed.

Saw two research studies, but can't seem to find them right now. Here's the closest thing:http://www.openbiomedical.org/getti...-growing-and-3d-printing-bones-of-the-future/

I see no difference between those two pics lol

Tbh, I don't like Joel Defrancq's work. Eppley is the best but he seems devoted to silicone.

 

[ZUZZCEL]

I dont thnk you relize how much more expensive peek and mephor are compared to silicone, the price difference really isnt worth it. Silicone just seems like a better option all around.

 

[Deleted member 399]

I dont thnk you relize how much more expensive peek and mephor are compared to silicone, the price difference really isnt worth it. Silicone just seems like a better option all around.

Titanium is expensive regardless of location but PEEK is cheaper in Europe. Silicone is cheap but risky. PEEK is the best material I've come across so far.
Not sure, but PMMA could work as well. Probably cheaper than PEEK.

 

[CopingCel]

Tbh, I don't like Joel Defrancq's work. Eppley is the best but he seems devoted to silicone.

He has lots of before afters withour any change, except for lighting. I have no idea why people are choosing him.

Not sure if Eppley is that great though. Eppley has allegedly botched quite some surgeries and ignores complaints about that instead of fixing his mistakes. He also does a whole lot of different surgeries. If you offer so many you can not possibly be an expert in all of them. On top of that he received a warning Letter from the FDA. He is a great marketer for sure, but I doubt he is the best surgeon.

 

[Deleted member 399]

If you offer so many you can not possibly be an expert in all of them.

Yeah I agree he does too much of everything but his expertise lies in patient specific custom implants.

Which surgeon do you prefer when it comes to getting implants?

 

[SurgerySoon]

He has lots of before afters withour any change, except for lighting. I have no idea why people are choosing him.

Not sure if Eppley is that great though. Eppley has allegedly botched quite some surgeries and ignores complaints about that instead of fixing his mistakes. He also does a whole lot of different surgeries. If you offer so many you can not possibly be an expert in all of them. On top of that he received a warning Letter from the FDA. He is a great marketer for sure, but I doubt he is the best surgeon.

What did the FDA warning letter say?

 

[crosshold]

i think displacement only occurs if the implant isnt screwed in

 

[Deleted member 399]

i think displacement only occurs if the implant isnt screwed in

Problem is that silicone is rather soft, making it prone to displacement even if you screw it in. That being said, I've seen Eppley simply slide silicone implants in without any screws or fixation LOL!

 

[CopingCel]

What did the FDA warning letter say?

http://www.circare.org/fdawls3/eppley_20060822.pdf

Yeah I agree he does too much of everything but his expertise lies in patient specific custom implants.

Which surgeon do you prefer when it comes to getting implants?

Not sure about that yet. It is difficult to judge them only by internet reviews and I am to far outside the us to do a consultation without having the money for the implant.

 

[ZUZZCEL]

Problem is that silicone is rather soft, making it prone to displacement even if you screw it in. That being said, I've seen Eppley simply slide silicone implants in without any screws or fixation LOL!

do you think its safe to get those bone ct implants or w,e in japan? are they custom made?

 

[Deleted member 399]

do you think its safe to get those bone ct implants or w,e in japan? are they custom made?

Honestly, they are supposed to be safe, but the jury is still out because its relatively a new concept that's just arriving in the west. They are custom made and patient specific.

 

[OCDMaxxing]

Silicone looks dogshit. You need fucking BONE

In Japan, they don't like the use of foreign materials and prefer to use calcium phosphate implants which integrates with the patient's bone and is converted into bone.

If this is true why the fuck are we not using it then?

 

[Deleted member 2846]

Silicone looks dogshit. You need fucking BONE

What about orbital rim implants?

 

[Deleted member 399]

Silicone looks dogshit. You need fucking BONE

PEEK is stronger than bone! Looks amazing tbh!

 

[Depressed Twink]

Eppley is the best ?lmao

Hes only so popular in the psl scene because he performs almost every surgery

 

[Deleted member 399]

Eppley is the best ?lmao

Hes only so popular in the psl scene because he performs almost every surgery

So who is the best in your opinion?

 

[OCDMaxxing]

PEEK is stronger than bone! Looks amazing tbh!

View attachment 109448
View attachment 109451

What is "PEEK"?

 

[Deleted member 399]

What is "PEEK"?

PEEK stands for Polyetherether ketone. Its a rigid biocompatible thermoplastic polymer with very good material properties. Similar to bone in terms of hardness.

Silicone looks dogshit. You need fucking BONE

If this is true why the fuck are we not using it then?

Regulatory issues and the fact that this technology has just been in developed in the last couple of years in the US.

 

[Andromeda88]

Dr.Eppley is great end of story.

 

[I'mme]

do you think its safe to get those bone ct implants or w,e in japan? are they custom made?

Better get them done in India with SM Balaji or Richardson or smbdy of their caliber.