While the array of facial implants has continued to increase due to new designs and the aesthetic needs created by the use of injectable fillers, off-the-shelf implant styles and sizes are not right for everyone. Facial asymmetries, failed or inadequate aesthetic outcomes from preformed implants and patient demand for unique implant shapes makes the concept of custom designed facial implants both appealing and necessary for some patients. While custom facial implants were once infrequently performed, they are far more commonly done so today. Technologic advancements in image acquisition and computer designing have made the use of custom implants both easily done and affordable. High quality 3D CT scanning at a relatively low cost is a prerequisite and is widely available at just about any CT scanning facility.

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CUSTOM FACIAL IMPLANTS



Facial Implants - David Dunaway & Associates
A Belgian girl suffered from hemifacial microsomia, a birth defect usually affecting the development of one half of the face and the second most common birth deformity in the craniofacial area. Professor Mommaerts from the European Face Centre was involved since the early stages of her treatment. Hemifacial microsomia is characterized by abnormal development in structures derived from the first and second branchial arches. This results in unilateral hypoplasia and asymmetry of the orbit, mandible, ear, facial nerve and overlying tissue with variable degrees of clinical manifestation. At the age of four she received a costochondral graft to create a functional and abutting joint to prepare her for a facial rotation procedure 10 years later. The doctors used a calvarial graft to reconstruct the zygomatic arch and repositioned the fossa to align with the contralateral joint position. This may stimulate some growth, but a facial rotation is always necessary and planned at the end of the secondary growth spurt.


Facial Implants
Cheek enhancement surgery is best indicated when the development of the cheek down is deficient. There is a continuum of treatment options between nonsurgical and surgical options. They also allow measurement of the target projection and customised sizing for the cheek implants. Volume augmentation with injectable filler is a good way to enhance the volume when smaller changes are desirable. When the target changes a more significant, the firm support underneath the soft tissues can be enhanced with implants for a more natural appearance.



Thank you for being you, for being dedicated, sympathetic to my worries, for being brave and bold as a surgeon, and yet being impeccably gentle with your work. You helped me feel whole again. Indebted to you Sir.