Custom Facial Implants
Montgomery AL

Introduction

Facial implants have been performed for years with excellent success, longevity, and safety. This is the most permanent reversible procedure there is. Why? The implant can simply removed or redesigned and replaced if for any reason you are unhappy.  Who is a candidate for facial implants? There are two main groups of individuals. The first is a person whom is interested in adding volume to a region of their face. They may have received fillers in the past to add volume. The second are patients whom have had surgery or trauma and now have an asymmetry or defect in the bone that needs to be addressed.

Custom facial implants represent a step forward in the evolution of this process. As they are customized to the contours of your anatomy they remain more stable and secure. They also are more easily placed at the time of surgery in the planned location and have minimal to no chance of migrating out of position; problems seen commonly in stock implants. Using Dr. Nizam’s prior training as a maxillofacial surgeon and 3d planning software, the implant is shaped with a biomedical engineer to meet your specific goals. Simply put this is something that will hopefully be present in your body permanently and there is no reason to compromise this. A great example is as follows; If you had to wear the same suit or dress the rest of your life, would you buy it off the rack at a store or would you have it custom tailored to fit your body?

Chin/Jaw

The chin and jaw are two of the most common areas augmented. Improvements in the appearance of the neck can be made with implants alone as the tissue is distributed over a larger area. There has been a recent trend in males in particular of augmenting the entire lower jaw, which is sometimes called a jaw wrap implant. Below are a series of cases demonstrating uses of custom facial implants.

The case above is an example of a female who wanted to maintain the overall shape of her chin however slightly narrower it, correct a small asymmetry, and lengthen the face. The implant was designed to accomplish these goals. This represents a smaller implant and is equal in volume to 2.5 syringes of HA filler.

Above is a common case Dr. Nizam sees. A male patient whom has had facial filler to augment a deficient jaw. Multiple syringes of Radiesse, which is made of CaOH were used. Unlike HA fillers, this can be visualized on CT, which makes this an interesting case study. As you can see filler migrates throughout the tissue even though it is injected into specific areas. This is why filler cannot produce a defined long lasting result. Even if it could, this case would represent the same volume as  15 syringes of filler. Financially this makes no sense.

Above is a post surgical defect. The patient had prior orthognathic surgery performed elsewhere. She has a cosmetic defect due to asymmetry of the right body of her mandible. Using planning software the jaw was mirrored upon itself creating symmetry, which would otherwise be difficult/unpredictable to reproduce with the patient’s own bone.

Cheek/Eye

The cheek and eye region are uniquely intertwined. People seeking implants in this region often have tried filler prior and liked the look, however want a more permanent defined look that filler cannot provide. Due to lack of projection of the cheek bone, some people have premature aging of the lower eyelid. Oftentimes implants are designed to add support and improve the appearance of the lower eyelid. Other people may simply have lost volume, which commonly occurs, with the aging process.

Above is a male patient whom had multiple syringes of filler. He was happy with the volume, however felt it looked to soft and desired a more defined look. Implants mimic bone far better and produce sharper results. He also desired a majority of his augmentation laterally and higher, as he is a male model.

This is an older patient who had lost a large amount of cheek volume over the years. He desired a permanent result. Fat transfer was considered, however he was too lean to have a meaningful source of fat harvest. As such, we decided upon a custom cheek implant that augmented the sub malar region the most. 

Process

First a consult is scheduled to determine if you are a good candidate and to determine what your goals are. This can be performed virtually with submitted photographs.  Next a CT scan is obtained. This is submitted to Implantech, the industry leader in custom facial implants. Dr. Nizam then designs the implant based of your anatomy and goals. If desired another meeting in person or virtually can be  made and the implant design reviewed. Design changes can be further refined. Once the implant is approved it takes 6 weeks to manufacture and deliver.

The procedure itself is performed typically under general anesthesia. Incisions for isolated chin implants are placed through a small incisions under the chin. If a full jaw wrap implant is planned incisions are placed under the chin and inside the mouth towards the back of the jaw and the implant inserted in 3 pieces. Incisions for cheek implants are placed from inside the mouth above the top teeth. Sutures are removed from under the chin at 7 days. Sutures placed in the mouth dissolve on there own. Results are seen immediately although swelling is present. Depending on the procedure this swelling can last from weeks up to a month. The contours will continue to sharpen up to 1 year.

Complications

Complications are typically minimal. They can include incision breakdown inside the mouth, infection, muscle disinsertion, temporary numbness and extremely rarely permanent numbness.  As stated prior one of the great things about custom facial implants are if you are unhappy with the size or shape it can easily be redesigned and exchanged.

Click here for Genioplasty Before and After pictures