Custom Facial Implant Questions
Dr. Eppley Q: Dr. Eppley, Can you please give me some information on custom facial implants? If I decide to go ahead with the procedure how much time do I need in the USA?
From the date that I arrive –
to have the CT scan,
to manufacture the jaw or skull model ?
To sit together and design the implant
To manufacture the implant
To leave hospital
To be able to leave USA ?
I am extremely concerned about infection – because I have just had cervical disc put into my neck. An infection my spread to them and create a big problem causing them to be removed.
Also extremely worried about pain – that is the one thing keeping me from going ahead – how can we totally control this ? Can I stay in hospital of the first couple of days so that I can get stronger IV pain medication \?
A: In answer to your custom facial implant questions:
1) The design and manufacture of custom facial implants is a 4 to 6 week process. Therefore patients get their 3D CT scan in their local geographic region and send it to me. I then take the scan and do the design process. Patients only come here for the surgery for the obvious practical reason.
2) The design process is done in sessions with engineers from 3D Systems. Patient do not directly participate in these actual sessions. I then take the design files and share it with the patients for their input. We have three design sessions to come up with the final approved implant designs.
3) The surgery time for a custom jawline implant is 2 hours.
4) If you are coming by yourself, and given your immediate pain concerns, you would stay overnight in the surgery center. This surgery is not performed in a hospital as that changes the cost of surgery significantly.
5) You would fly home when you are comfortable doing so. Each patient is different but I would give yourself at least 5 days after surgery before leaving.
6) While infection is always a concern in jawline implant surgery, I would have no concern about it spreading to your cervical disc implants should it occur. When occurring it remains localized to the implant pocket.
7) While the most common postoperative custom facial implant issues are aesthetic in nature, infection is the one medical issue that we pay a lot of attention to try and avoid through a host of strategies. But infection is not something that ever occurs immediately, its occurrence is always in the range of 3 to 6 weeks after surgery…a time that surprises patients as they think they are well past it at that point.
8) While every patient is different about pain, that has never been a postoperative issue that has been a problem with any custom facial implant patient. You may every well be different in this regard although I would think your cervical disc surgery would have been far more painful than jawline important. While one would receive IV pain medication in the overnight stay int the surgery center, there is no capability to go to a hospital for IV pain medication after the first night after surgery.
9) Pain is not something I worry about in any patient as that seems to be well controlled by standard pain medication. What I do worry about is that few patients are psychologically prepared for the large amount of facial swelling that will occur (from the patient’s perspective) and the duration of time that it takes to go away. This can be very psychologically destabilizing for some patients…and they are always the male patients that have the most difficulty with it.
Dr. Barry Eppley