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…

Reported rates of infection amongst the four materials used in custom facial implants, silicone, PEEK, porous polyethylene and titanium, is hard to define clinically, There are too few clinical studies and some of the materals have very low use in aesthetic facial augmentations (e.g., titanium) As a result laboratory evidence of the ability of bacteria Read More…

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…

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…

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…