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The Need and Benefits of Custom Facial Implant Designs

The number and types of off-the-shelf facial implants styles and sizes has expanded  over the past twenty  years to address patient’s expanding aesthetic desires. Along with increased implant options the different types of materials used to make them has also increased.

Besides changing facial beauty standards, the widespread use of injectable fillers and fat injections has made many patients aware of facial dimensional changes that they may find both pleasing and possible. The often transient effect of fillers and fat as well as the costs incurred in continuing those treatments over many years will have some patents seeking more permanent results through the use of implants. While implants are more invasive and are not without their own risks, their capabilities are tremendously expanded when they are custom designed for the patient’s specific anatomy and aesthetic needs.

While formerly known for use only in facial reconstructive facial surgery, custom facial implants now has a major impact on facial aesthetic surgery as well. The request for specific facial changes and inadequate outcomes from the use of off-the-shelf implants fuels the increasing demand for a custom-designed approach in aesthetic facial augmentation.

While once costly and time intensive, technologic improvements in 3D CT scanning and software designing has made the consideration of custom facial implants both convenient as well as an affordable facial augmentation option. From high-resolution 3D CT scans that are widely available just about anywhere the facial implant design process can be initiated. What saves a lot of time today is that the entire implant design process is done online. While historically done using 3D printed plastic models of the patient’s face from which the design was hand made, it is a digital process today. This shortens the design process which shortens turnaround time from the getting the 3D CT scan to having the custom implant available for surgery in weeks as opposed to months.

Custom facial implants can be made from a variety of different materials from silicone, Medpor, PEEK/PEK and titanium. I have made custom facial implants out of all of these materials. While I have no predilection for one material over another, it is important to appreciate that the material used will influence the design, how it is surgically placed as well as the cost of the surgery. The reason that solid silicone is used most frequently is because its flexibility and elastic deformation properties enables it to be placed through the smallest of incisions in the largest size or amount of bony surface area coverage possible. The more rigid the material the larger the placement incisions must become and/or the implant must be sectioned into multiple pieces for passage into the tissue pocket. As a result, the material’s composition/firmness has relevance as many custom-designed facial implants are large or have more complex shapes than off-the-shelf implants.

Custom Facial Implant Types

The computer design process allows custom implants to be made from the top of the head down to the lower jaw. Such  designed implant shapes are only limited by the surgeon’s ability to place them through aesthetically acceptable incisions. This opens up whole new possibilities for what implants can offer the aesthetic facial surgery patient. It also important to note that custom facial implants are also creates the need for modified techniques for their placement and intraoperative positioning.

Dr. Barry Eppley

Indianapolis, Indiana

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