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.
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Alabama Surgical Arts
Patient Review by Terri H
The office is very welcoming and the staff friendly. I felt at ease with my procedure.
- Terri H
Patient Review by Linda
Great and friendly staff. Appointment was easy to schedule. I am happy with my procedure and will follow up again. I would recommend Alabama Surgical Arts for anyone.
- Linda
Patient Review by Kathy R
Wonderful they are very professional and really care about their patients. I wouldn’t choose to go anywhere else.
- Kathy R
Patient Review by NANDAGOPAN P
I received very good care and treatment. I was impressed when the doc called up later to check on me. Normally like anyone else, I hate a visit to the dentist , but this was a really pleasant experience. Thanks.
- NANDAGOPAN P
Patient Review by Aletha B
Lily is great!!!
- Aletha B
Patient Review by PBHS T
It was a great experience from start to finish!
- PBHS T
Patient Review by Latoya
Alabama Surgical Arts was amazing. Doctor Sami Nizam did a wonderful job putting me at ease with the nervousness I had during the procedure. I had no pain the next day even though I couldn’t get my prescriptions filled until the next day. Bleeding was minimal. I will definitely be returning for future procedures. Great Job Guys
- Latoya
Patient Review by Mark A
Dr. Nizam performed my maxcillofacial surgery @ UMDNJ. Dr. Nizam and his staff did a 360 degree in making a difference in my life, he's very gifted. I've never had any post surgery issues and its been 3yrs and counting.
- Mark A
Patient Review by Miriam C
I can across dr. Sami Nizam by coincidence after seeing 4 other oral surgeons that couldn’t even explain to me what is wrong w my teeth. All I got was the estimate on the cost. When I met dr. Sami Nizam he took his time to explain to me what was the issue, showed me the pics n shortly after he did total of 4 surgeries on my teeth including the plastic surgery on my gums to cover all the scars. He always checked on me after the surgery if I’m doing ok. Thanks to him I have my beautiful smile back. Than I found out he does fillers so I had him do my lips. He’s very knowledgeable doctor. I highly recommend.
- Miriam C
Patient Review by Shannon A
Dr. Nizam is amazing! I have had both Botox and Juvederm injections. He took the time to speak with me about my area's of concern and discussed all of my options with me. I wanted a very natural look and wanted to make sure that I didn't look over done. I love, love the results. I will recommend Dr. Nizam to all of my friends!
- Shannon A
Patient Review by Richard L
Oh yes definitely Dr. Nizam is among the best!!! I had five extractions and six implants placed on my upper jaw with a permanent porcelain denture. While sleeping, completely painless amazing results. Two thumbs up
- Richard L
Patient Review by Linda K
For over 20 years I suffered from periodontal disease and was a patient of a well respected Periodontal specialist in Philadelphia. During that time, the intent was to keep my teeth and gums as healthy as possible. Regularly scheduled deep cleaning worked. However, my doctor retired and the new staff had different ideas. The regularly scheduled deep cleaning was no longer an option, and within a couple of years my teeth deteriorated to the point where it was embarrassing to even smile. The new staff recommended extractions, at first only a few teeth. Ultimately, they planned to extract all my teeth and do implants. I agreed to have the first three teeth extracted. That was the beginning of a horrible time for me. After the extractions I bled profusely and was in a lot of pain. For two weeks I continued to bleed on and off. I was frightened ,I could not eat, and I was miserable. As time passed it didn't get much better, and I was not myself, as I was normally very outgoing and talkative, but now became very uncomfortable around people. The staff then recommended extracting the rest of my teeth and doing implants. But I was afraid of what might happen after the last experience. I thought, "if I bled so profusely from 3 extractions, how would my body react to all my teeth being extracted". The thoughts going through my head were all scary and uncertain. I sought out other opinions, but did not have a good feeling with anyone. Finally, in late 2016, I met with Dr. Sam Nizam. When we met, I immediately felt the connection, and I was comfortable. Dr. Sam listened to all my concerns attentively. I knew the qualities in a doctor that I was looking for and Dr. Sam had all of them. Dr. Sam sat me down and explained step by step what he recommended and how the procedures would be done. He was so calm and confident, and did not sugar coat anything. He explained that I needed 26 extractions, and why. He explained that I needed bone grafting for the implants to take, where he would need to do the grafting, and why. He explained that I needed a sinus lift, and where and why. Also, he showed me visually on the computer and pointed out exactly where my implants would be placed, to have the best chance of success. He explained how all procedures would be done at the same time. I was still nervous about the whole process, but I had total confidence in Dr. Sam and agreed to schedule it as soon as possible. It was February, 2018. I was in surgery for 5 1/2 hours. He performed all the work that he had explained to me. I went home, knowing I was in good hands and that I was going to be fine. But I was just a little nervous, thinking I might bleed. Dr. Sam prescribed pain killers, which I took that night and went to sleep. I awoke after a peaceful night sleep. My bleeding was the size of a dime!. I had minimal pain. I stopped taking the pain killers. I went back for a follow up. Dr. Sam was pleased with the results and so was I. No pain, no bleeding, the implants (all 11 of them) all took. I now have new teeth. I can smile again. I can speak without fear and embarrassment. At my daughter's wedding I was able to proudly smile and laugh all night! Dr. Sam gave me my life back! I am myself again! Thank you!! I will always be grateful to Dr. Sam for the incredible work he did, that now gives me the chance to enjoy life as I had not been able to do for so long. If I ever have a problem, even though I now live many states away in New Jersey, I would not hesitate to make the trip. I recommend Dr. Sam highly . He has been blessed with a tremendous talent and gift to help people. I wish him all the best,and pray that his success helps thousands more like me in the future.
- Linda K
Patient Review by Rosa W
I’ve had my eyebrows microbladed by Lily about half a year ago and I’m super pleased with result. I didn’t have a lot to work with and it was amazing to see the results. Not to mention, she is so personable and fun! Check out their Instagram if you don’t believe me. Lily Nizam and Dr. Nizam are both very professional and work very hard to make sure you get the best treatment and results. I’ve seen it with my very eyes!
- Rosa W
Patient Review by Pearl T
The staff was amazing, The Dr. Is well educated and made me feel so comfortable. I didn't feel any pain during it afterwards his wife is amazing and helpful they all make you feel at home.
- Pearl T
Patient Review by Samantha S
Dr. Nizam was amazing!!! I received fillers and Botox over a year ago and everything still looks great. I had my Botox updated, but the fillers still look wonderful. Thanks Dr.Nizam for giving me a refreshed look.
- Samantha S
Patient Review by Zayna A
Over the course of my treatments, Lily has easily become a great friend. Although I had some reservations before starting my laser treatments, Lily made sure to put my mind at ease. The results of my treatments have honestly been great, all thanks to her. She will be dearly missed in Arkansas, but I wish her all the best in Alabama!!
- Zayna A
Patient Review by Suzanne M
Lily is the best ! I was very hesitant about having anything done because I was a first-timer for any cosmetic procedure. She put me at ease right away by talking to me about my concerns and answered all my questions. She has the expertise as well as an artist's eye ! She did a threadlift on me recently and before that she did tear trough filler. I was very happy with the results! The thread lift results were amazing yet very subtle and natural. Although she's no longer in Arkansas , I would travel to Alabama to see her in a heartbeat!
- Suzanne M
