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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…

The High Cheekbone Look in a Female Case Example

The “high cheekbone” look that many women seek is less about having large cheekbones and more about the relationship between the cheekbone, the under-eye area, and the lower face. Models and actresses with striking cheekbones typically have a combination of skeletal anatomy, soft tissue distribution, and low facial fat that creates light-shadow definition. The desired Read More…

PEEK Facial Implants – Part 3. What A Modulus Closer to Bone Really Means

In facial implant materials a key distinction is between “bone-like stiffness” being mechanically necessary and simply being a useful material characteristic. For most aesthetic facial onlay implants, the second description is more accurate. Think of a custom PEEK mandibular angle implant. Its job is primarily to create and permanently maintain a new skeletal contour. It Read More…

PEEK Facial Implants – Part 2. The Elastic Modulus of Bone and Its Relevance to Aesthetic Facfal Implant Materials

For an onlay aesthetic facial implant, having an elastic modulus closer to bone is potentially helpful, but the benefit is somewhat different—and arguably less important—than it is for a load-bearing orthopedic implant. Elastic modulus is essentially stiffness: how much a material deforms for a given stress. PEEK (~3–4 GPa) is dramatically less stiff than titanium Read More…

PEEK Facial Implants – Part 1. Mechanical Properties and Clinical Advantages

PEEK (polyether ether ketone) is a high-performance thermoplastic that has become increasingly popular for patient-specific facial implants because it combines high strength, dimensional stability, radiolucency, and a bone-like elastic modulus. Its mechanical properties are generally superior to porous polyethylene (Medpor) and more similar to cortical bone than titanium in terms of stiffness. Here’s a summary Read More…