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The custom design and manufacturing process allows a virtual unlimited number of facial implant styles and sizes to be created. There is almost no implant shape that this process can not make if desired. Unlike standard facial implants, whose effects are limited by their smaller shapes and sizes, custom facial implants allow their resultant external soft tissue effects to achieve aesthetic results not previously seen.

The key to harnessing the effects from custom facial implants is two fold. First and foremost it is important to have an appreciation of what the overlying contour changes may result from the unique and often larger implant shapes and bony surface area coverages. While this is straightforward when treating bony facial asymmetries (matching the deficient side to the good side), pure aesthetic augmentations require greater patient interaction and a clear understanding of their aesthetic desires. Unfortunately it is not an exact science in determining how to design a facial  implant to achieve a specific aesthetic effect. While facial measurements, ratios and even the Golden ratio and proportions can be applied to the design, this is not a guarantee that the desired outcome will be achieved. A surgeon’s experience in custom facial implants remains the current best method to navigate the gap between design and its facial effects.

Secondly, custom facial implants are often larger than standard implants and consideration must be given to the location of the incisions through which they are to be introduced. How is the implant going to fit through it and be properly positioned and secured once inside the tissue pocket. While this may not be a significant issue in standard facial implants due to their smaller size, it is a major consideration in most custom implants.

Today many surgeons still think of custom facial implants as being an exclusive  reconstructive technology. Too often surgeons try to use standard implants for non-standard problems and/or try and create a patchwork of standard implants to create a specific aesthetic result. Such familiar strategies often aesthetically fail as that is not what standard facial implants were designed to do. As the name standard implies, their intended use is for common aesthetic problems for which a modest change is acceptable. Filler and fat injection therapies have expanded patient awareness to aesthetic facial results that are often only achievable by custom facial implant designs. As a result the true value of custom implants is actually far greater in aesthetic surgery where larger numbers of patients exist who may benefit by them.

Dr. Barry Eppley

Indianapolis, Indiana

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