Could One Of My Paranasal Implants Be Upside Down?

Q: Dr. Eppley, I had paranasal implants placed four months ago. Is it  possible you could have put one of the implants upside down.?I ask because even since the beginning of healing I can feel around the peripheral of each implant and the shapes are totally different. I have been wondering for a while. I say this because I truly wonder if its upside down. Even I can see that the fleshy higher cheek on the right was improved right next to to the lateral nostril but the fleshy cheek on the left is a lot flatter next to the nostril but then highe up the area comes forward.  It is like they one is flipped upside down from the way it looks and feels.

A: I would say that the chances of a paranasal implant being upside down is very unlikely. And I say that for three specific reasons; 1) The shape of the implant has a convex and a concave side to fit into the concave shape of the paranasal region. Trying to make it fit upside down would be very obvious as it wouldn’t lay flat against the bone very well, 2) Each implant has an L (right side) or a reverse L shape (left side). Putting it in upside down would have the L facing the wrong way which would be very obvious, and 3) When placing a small screw to fix the implant to the bone, it is put into the outer flange of the implant and is only 5mms long. If the implant was flipped, its outer flange would be sticking up and the screw would not be long enough to get to the bone.

Having said that, because of the paired nature of facial implants (cheeks, paranasal, jaw angles), slight differences in their positions between the sides can be really obvious. This is particularly true the closer one gets to the facial midline. (paranasals) If the implants are even off a few millimeters up or down or side to side, such differences can be easily seen and felt. That is is the more likely scenario with your paranasal implants than that one has been placed upside down.

Dr. Barry Eppley

Indianapolis, Indiana