Use of rapidly hardening hydroxyapatite cement for facial contouring surgery

Hydroxyapatite cement is an ideal alloplastic material to replace the autogenous bone grafts in craniofacial surgery. Hydroxyapatite cement is advantageous because it can be easily molded by hand unlike other alloplastic materials such as silicone and high-density polyethylene. For aesthetic applications of hydroxyapatite cement, we evaluated the efficacy and safety of the rapidly hardening hydroxyapatite cement used in facial contour augmentation, especially for the forehead and the malar area. A total of 18 cases of facial skeleton augmentation or contouring surgery using rapidly hardening hydroxyapatite cement (Mimix; Biomet, Warsaw, IN) were examined, and the long-term cosmetic results and any complications were also analyzed. The aims of facial contouring surgeries were to correct the following conditions: hemifacial microsomia, craniosynostosis, posttraumatic facial deformity, deformity after tumor resection, dentofacial deformity, and Romberg disease. The application sites of hydroxyapatite cement were the forehead, malar area, chin, and paranasal area. A mean of 16 g (range, 5-50 g) of the hydroxyapatite cement was used. Postoperative infection, seroma, and migration of the implant were not observed during the follow-up period of 23 months. Rapidly hardening hydroxyapatite cement, Mimix, is easy to manipulate, promptly sclerotized, and can be replaced by living bone tissue, with a low complication rate. Therefore, it can be an optimal treatment that can be used instead of other conventional types of alloplastic materials used in facial contouring surgery.