How Are Custom Facial Implants Properly Sized?

Q: Dr. Eppley, I hope you remember me, I came in for a consultation with you awhile back. At any rate, the procedure I was discussing with you was a custom chin/jaw implant. You are and are still my surgeon of choice/my top pick for this procedure and I wanted to move forward with you yet you was out of my price range. So I found a surgeon locally that was more within my budget and who had done one custom chin/jaw procedure and several pre-fab procedures. But, I think despite our best efforts to ‘play it safe’, and size the implant to appropriate proportions to my face/head, it appears as if we’ve inadvertently gone overboard in at least one dimension/direction of the implant. I’ve just had the surgery in early January so it’s only been less than three weeks. (and of course I realize I’m looking at a good amount of swelling right now). Are you available to consult with me via phone and/or Skype? I’m thinking I may need to redesign another implant, and I’m interested in having you help me in redesigning it. It would be greatly appreciated and I could really use your help.

A: It is extremely common that a patient (if they so insist) or a doctor (who has little to no experience with custom facial implants) unintentionally makes a custom implant too big. While a certain implant design and size make look good on the 3D CT scan model, it can not factor in what it will really look like on the outside when the overlying soft tissues ar covering it. I have made this implant design mistake myself in my earliest days of custom facial implant use. It takes experience to know how certain implant thicknesses impact the final augmentation result. This is why it is so dangerous to take measurements straight from the face and believe that is what the implant thickness should be.

Dr. Barry Eppley

Indianapolis, Indiana