Custom Facial Implants vs Standard Facial Implants
Q: Dr. Eppley, I am confused about the differences between standard and custom facial implants. A custom approach would seem to be better since their shape would be more assured to achieve the desired facial shape change. Since facial implants are not adjustable during surgery one would want to have the best implant shape possible going into surgery.
A: Let me provide with some further clarifications as misconceptions about standard and custom facial implants are understandable common.
1) All facial implants are made of malleable material which is always adjustable whether it be shape (reduction) or adaptation to the bone. (shape and/or implant fixation) Such adjustments are commonly done even on many custom facial implant cases. The only feature of any facial implant that is not alterable is that volume can not be added to it.
2) Custom implants are made from the patient’s 3D CT scan. But what those size and shape dimensions of the implants should be for any patient’s aesthetic desires is an artistic guess for which the surgeon and patient have no assured way of knowing the actual outcome. The computer can certainly not tell us, it only creates what it is told to do. Whether the ‘input’ is the desired patient’s ‘output’ is not always 100% predictable.
3) As a result of #2, over 50% of patients that receive custom facial implants go on to have revisional surgery or have new custom implants made to get closer to their desired aesthetic facial result.
4) Patients that have indwelling facial implants, like you, have an advantage in custom facial implant design because they have a known external aesthetic effect from their previous surgical efforts. That does help in knowing how to improve their existing facial implant shapes and sizes. But this does not make such a patient immune or eliminate the risks of undesired aesthetic outcomes or implant asymmetry in bilateral unconnected implants.
Dr. Barry Eppley