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Dr. Yaremchuk:

Custom made (“bespoke”) facial implants – an example

Below are images derived from a cone beam CT (CBCT) scanner following a patient consultation. In this case, the patient desired to correct the asymmetry in her lower jaw, as well as create a more defined chin and more prominent cheek bones. Bespoke facial implants were designed to provide these skeletal changes, which would be reflected in the contours of her soft tissue envelope.

The image in the upper left hand corner shows the “before” or preoperative appearance of the patient’s soft tissue envelope. The image in the upper right shows the patient’s underlying skeleton.

The image in the lower right shows the effect on the patient’s soft tissue envelope resulting from the desired skeletal changes from the custom made bespoke implants overlying her native skeleton. The predicted soft tissue envelope appearance in the lower right image is obtained by increasing the soft tissue projection an amount equal to the amount of increased skeletal projection provided by the implant thickness. This is currently the best estimation of the end result possible, and is invaluable to patient understanding during consultation.  

Click here to see before and after patient examples of bespoke plastic surgery.
[Note: Blunting of the nasal tip is a result of head positioning in the scanner].

C. 2005   Michael J. YAREMCHUK, M.D.    all rights reserved