Can A Premaxillary Implant Be Placed With A Deviated Septum?
Q: Dr. Eppley, I have quite significant nasal deviation and also maxillary retrusion from unilateral cleft lip and palate. To create fullness in that area I have inquired about orthognathic surgery and was told that the removal of teeth when I was younger makes that almost impossible. I was wondering if theoretically it is possible to put premaxillary implants in with a deviated septum that needs correcting. Does the premaxillary implants stabilize the septum?
A: When a Lefort I or maxillary advancement is not possible, onlay facial implants can provide a similar aesthetic effect. (with the exception of the effect on the upper lip by the anterior tooth movement) Midface augmentation could include premaxillary, paranasal, maxillary and/or cheek augmentation. These are all different types of facial implants to augment various areas of the midface. An entire custom midface implant can also be made from a 3D CT scan. Placing any of these implants is not influenced by any form of septal correction. Septal straightening is needed in every cleft patients and how it is straigthened and its stability is not changed or influenced if a premaxillary implant is done at the same time.
Dr. Barry Eppley
Indianapolis, Indiana

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