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Facial Cosmetic Surgery using 3D Design
 
 Facial Cosmetic Surgery using 3D Design
 
With the evolution of 3D printing technology, it is more and more implemented in the practice of facial cosmetic surgery. Traditional implants has been used in in facial cosmetic surgery procedures, such as rhinoplasty, forehead augmentation, chin augmentation and nasolabial fold correction. However the outcome is not ideal because the traditional implants do not ensure a seamless fit between the implant and the underlying implant, which may lead to complications, such as implant displacement, bone erosion and increased risk for infection. Nowadays 3D imaging (CT scan) combining 3D design technology can be used to create custom implant tailored to a patient’s anatomy.
 
Currently bone cement is the only kind of implant material that can be applied for 3D design techniques. Bone cement, also known as acrylic bone cement, is a biomaterial composed of polymethylmethacrylate (PMMA) with self-curing property that is surgically used as space filler to hold the implant against the bone or fill the bone cavities. Since its first time use in 1958 in total hip replacement to fix the femoral prosthesis, bone cement has been widely used in orthopedics.
 
The main application of bone cement in cosmetic surgery is facial contouring of forehead, chin and cheek bones, to correct flat, hollow forehead, receding chin, sucken mid-face and saddle nose. Bone cement is the only biomaterial that can be applied in cosmetic surgery incorporated with 3D computer simulation and 3D printing technology to create custom prosthetics on forehead, chin, nose and mid-face.
 
During the first consultation, the patient can discuss with the doctor about what they desire to achieve, and the doctor can use 2D simulation software to show the predictive surgical outcome based on what the patient wants or what the doctor can do. If the patient is satisfied, CT scan is undertaken combing with 3D software to simulate the facial bone model of the patient. For example, in the case of chin augmentation, , the doctor can graphically simulate the desired contour of the chin based on the 3D CT scan images, and then the computer engineer will design and fabricate the implant in the size and shape that match the requirement.
 
 
 
 

During the second consultation, doctor can show the simulation images to the patient. After detailed discussion and careful amendment, the computer engineer will produce the so-called negative mold (require about 2 weeks). The doctor can later fill the negative mold with bone cement to create a custom chin implant during the surgery.
 
After discussion with the patient, we will cooperate with the computer engineer using 3D design software to design and simulate the implant based on individual patient’s need.
 
Case of forehead contouring cased on 3D modeling
 
 
 
Currently 3D printing technology can be applied to facial plastic surgery procedures including forehead augmentation, cheek augmentation, nasolabial fold correction, genioplasty, 3D bone cutting guide and orthognathic surgery planning. This is a milestone in customization of facial cosmetic surgery, which not only shorten the surgery duration, but also ensure more accurate surgical outcomes.
 

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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