Blog

Finite-Element Modeling in Custom Facial Implants

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…

The Modern Midface Augmentation Patient – Skeletal and Soft Tissue Considerations

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…

Comparing Silicone vs PEEK Custom Jawline Implants – Surgeon’s Perspective

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…

Comparing Silicone vs PEEK Custom Jawline Implant – Patient’s Perspective

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…

The Six-Piece Custom PEEK Jawline Implant

Why do custom PEEK jawline implants with larger jaw angle segments have the jaw angle segment split into two pieces changing a four piece to a six piece implant design? With PEEK, the reason can be even more restrictive than with a large silicone jawline implant: the problem is not simply the total number of Read More…

How To Design a PEEK Jawline Implant for Optimal Intraoperative Placement

The success of any jawline implant is a combination of design and placement. It doesn’t matter how well an implant is designed if its placement on the bone doses not correlate closely to the design file. Accurate placement is a combination of surgical skill and various design features. An implant’s design can help or work Read More…

PEEK Custom Jawline Implant Placement Challenges Case Example

A PEEK wraparound jawline implant usually needs to be made in multiple pieces because PEEK is very rigid. A full jawline implant can extend from one mandibular angle, across the chin, to the opposite angle. Unlike silicone, PEEK cannot flex enough to pass that entire shape through the relatively small incisions used for placement. Dividing Read More…

Custom Facial Implants and Infection Risk – Part 3. Nonporous Smooth Surfaces (Silicone vs PEEK)

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…

Custom Facial Implant Materials and Infection Risk – Part 2 Surface Energies

One material property i occasionally hear about implants and infection risk is surface energy. This is usually mentioned in regard to silicone materials and their low sueface energy which may help them be more infection resistant. Not necessarily. Silicone’s low surface energy does not make ordinary medical-grade silicone inherently infection resistant. In many biologic environments, Read More…

Custom Facial Implant Materials and Infection Risk – Part 1. Bacterial Surface Adhesion

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…