Q: Dr. Eppley, I am going to have a custom facial implant procedure and am participating in its design. I would like to have an implant that creates a dramatic amount of a facial augmentation effect. My surgeons seems skiddish about such a large custom facial implant design. What do you think?
A: While I have no details about your custom facial implant design, your desires probably are coming close to making a classic custom facial implant implant design mistake. Just because it can be designed and it fits on the implant model, that doesn’t mean it will actually fit in you during surgery. Implant designing must take into consideration the soft tissue cover and how thick or thin it is. That is knowledge that the surgeon has that patients don’t. I have also learned, and more painfully so for those patients involved, that lack of consideration of the soft tissue layer can result in major complications that have led to the need to remove the implant. It is important in any custom facial implant design to not get too greedy. Reaching for the maximum implant design often leads to complications. It is far better to have an uncomplicated outcome that is 70% to 80% of the desired result than obtaining 100% of the desired result with a complication.
Dr. Barry Eppley