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Laryngeal Fracture Plate Removal

Titanium miniplates used to stabilize thyroid-cartilage fractures are generally left in place when they are asymptomatic. The published laryngeal-fracture literature does not establish routine removal at 6–12 months; reports describe retained plates with good airway, swallowing, and voice outcomes at follow-up extending from several months to two years. Evidence specifically addressing elective plate removal from Read More…

Eppley Custom Jawline Implant Design Protocol

I structure the custom jawline implant design process around one central principle: design toward a defined postoperative facial shape, not toward an implant thickness. The core concept is: implant geometry is the translation of an aesthetic goal into a safe, stable, anatomically blended 3D skeletal shape, with the largest augmentation where change is needed and Read More…

The Inverse-Design Method for Custom Jawline Implants

For a custom jawline implant, the best results usually come from treating the problem as an inverse-design problem: define the desired postoperative external jaw contour first, then work backward to determine the implant geometry needed to produce it. The key is not simply designing an implant that “looks good” on the mandible. As some implant Read More…

Custom Implant for Midface Advancement/Augmentation – The Three Zone Concept

For most implants whose goal is midface augmentation,their design and manufacture should be thought of as a three zone concept  in which the anatomy/design relationship can be summarized as follows: Zone Anatomy Design purpose Surgical-planning issue 1 — Infraorbital / anterior maxilla Infraorbital rim and upper anterior maxilla Improve negative vector and upper-midface projection Infraorbital Read More…

Custom Implant for Midface Augmentation Design Considerations

For a custom integrated midface implant intended to create the visual effect of midface advancement, I’d divide the construct into six itheoretical nteracting zones rather than treating it as one uniformly thick shell. Zone Design objective Contour concept Critical constraints 1. Infraorbital rim / anterior maxilla Correct negative vector, tear-trough skeletal deficiency, and upper-midface retrusion Read More…

Custom Implant for Midface Advancement/Augmentation

A patient-specific midface implant can be designed to create an advancement/augmentation effect across much more than the conventional malar eminence. The key distinction is that it changes facial skeletal contour, but it does not literally advance the maxilla, dentition, or airway the way an osteotomy does. Alloplastic augmentation has been described as either an adjunct Read More…

Multiple Piece PEEK Jawline Implant Placement

Why do PEEK wrap around jawline implants need to be placed in multiple pieces? The main reason is PEEK is too rigid to safely insert a full wraparound jawline implant as one continuous piece through the small surgical access incisions. A custom wraparound implant may extend from one mandibular angle, across the body and chin, Read More…

Large Temporal Artery Prominence Ligations in a Male Case Example

In the treatment of large, prominent superficial temporal artery (STA) in a male patient for cosmetic reduction, the important issue is that simply tying off one visible point will not reliably eliminate the vessel. It requires a multi-level ligation technique for assured effectiveness. The STA has a collateral-rich network. Its frontal and parietal branches communicate Read More…

Technical Strategies – Reducing the Prominence of the Upper Ear

An upper-ear setback otoplasty is a targeted form of otoplasty designed to bring the upper third of a prominent ear closer to the head, rather than repositioning the entire ear. It is commonly considered when the upper ear projects at a noticeable angle from the side of the head because of an underdeveloped upper antihelical Read More…

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