Subperiosteal versus epiperiosteal forehead augmentation with hydroxylapatite for aesthetic facial contouring: experimental animal investigation and clinical application.

The difference between periosteal and subperiosteal application of hydroxylapatite (HA) in aesthetic forehead augmentation in the subimplant bed was investigated in six adult Göttingen minipigs. These results were then transferred to clinical application. One exemplary case is described. We found that epiperiosteal augmentation with hydroxylapatite should be performed only if shape and location are stable. Subperiosteal augmentation with hydroxylapatite must be judged critically since HA particles migrate into the subimplant bone.