For custom infraorbital–malar augmentation, I’d generally favor PEEK when the goal is true skeletal reconstruction with exact CT-based contour, and silicone when the goal is primarily aesthetic augmentation and you value intraoperative adjustability/reversibility/optimal implant design. There is no literature specifically comparing custom PEEK with custom silicone in this exact anatomic zone so much of the decision Read More…

For a male “high cheekbone” look, I would design the implant quite differently from one intended to create generalized midface fullness or any other standard cheek implant. The key is a high, lateral, relatively angular zygomatic augmentation, not simply a bigger or more highly positioned malar implant. The implant’s maximum projection should sit high on Read More…

Finite-element modeling—usually called finite-element analysis, or FEA—is a virtual mechanical test of the patient-specific implant–fixation–bone–soft-tissue system. It can be used before manufacturing to compare implant thickness, material, footprint, screw positions, edge geometry, porosity, lattice structure and fixation stiffness. Patient-specific maxillofacial workflows increasingly combine CT-derived anatomy, CAD design and procedure-specific FEA to identify regions of excessive Read More…

Today’s midface augmentation patient is less often asking simply for “bigger cheeks.” More commonly, they are seeking better facial structure, balance, and restoration of youthful contour without looking filled or operated on. There are several common patient profiles:   The younger structural patient, often in their 20s–40s, has congenitally flat or underprojected malar bones, a Read More…

As a surgeon I have to think a variety of technical issues when comparing materials for custom jawline implants. These include incision strategy, screw fixation, mental nerve considerations, implant thickness, long-term bone changes, revision/explant technique, and how I would counsel a cosmetic patient choosing an implant material.. For a custom wraparound jawline implant—chin + mandibular Read More…

For a custom jawline implant, both solid silicone and PEEK can work well, but they behave quite differently surgically and biologically. There is not strong head-to-head evidence showing that one is universally superior; much of the published custom-implant literature is observational and PEEK-specific rather than direct PEEK-versus-silicone comparison. Feature Custom silicone Custom PEEK Consistency Flexible Read More…

For custom facial implants, the most useful way to think about silicone versus PEEK is that both can be manufactured as dense, nonporous implants, so the comparison becomes much cleaner than silicone versus Medpor. Once porosity is removed, surface finish and biologic conditioning probably matter at least as much as the polymer’s nominal surface energy. Read More…