Custom Facial Implants

Q: Dr. Eppley, I have been researching plastic surgeons who specialize in custom facial implants and was particularly interested in finding a specialist who uses 3D technology to create the implants custom for their patients. I came across Dr. Eppley’s website while researching and was pleasantly surprised to find that he uses this in his practice. 

I am looking for something very specific. I have no serious issues with my face, rather I am simply looking to enhance my attractiveness through creating more symmetry and creating angles that fit within the Marquardt mask beauty dimensions.

My goal is to have a 3D scan of my face done. (I do understand this requires a CT scan) Then have the Marquardt mask/dimensions superimposed onto my existing facial structure. Then from the mask application combined with measurements and the surgeons expertise see where implants would be needed and exactly the measurements and dimensions each implant should be in order to achieve this level of heightened symmetry and beauty.

As the face is asymmetrical I anticipate each implant would be customized to created the most natural balanced look. Then through the same 3D technology be able to see how I would look after the implants were put in.

I am looking for a natural and subtle look as the outcome.

A: I do many custom facial implants in my practice which involves the use of a 3D CT scan and designing software/engineers through a company known as 3D Systems. While the 3D process is the ideal way to make facial implants and augment the face, you do have some common misconceptions about the implant designing process.

First, the implants are designed from the 3D CT scan using very sophisticated designing software. This is a bone-based design, not a soft tissue one. The Marquardt beauty mask is based on soft tissue measurements, not bone. Thus it can not be used to overlay on the bone to determine the implant designs.

Second, the design of custom facial implants is an art form. The computer does not tell the surgeon or the engineer how it should be designed, it is the reverse.The surgeon tells the engineer how to make the implant design. The computer makes sure it then fits the bone perfectly, is symmetric if there are paired implants, has smooth contours and feather edge transition into the surrounding bone. But as of yet there is no software application where the ideal facial bone structure or a beauty mask can be used in the design process.

Lastly, regardless of the implant design, the computer can NOT then show what they will look like on the external face. There is no software yet to be able to make that prediction.

In short, custom designed facial implants are always better than using standard ones off the shelf, particularly in cases of asymmetry. But the shape and dimensions of the implants and what the postoperative result may be currently remains part of the art of custom facial implants.

Dr. Barry Eppley

Indianapolis, Indiana