Facial implants have come a long way from bone grafts and steel plates. In an exclusive interview with American Health and Beauty, pioneer in Custom Facial Implants, Beverly Hills facial plastic surgeon, Dr. William J. Binder spoke about the origins of the revolutionary 3-D technology that transformed facial implants as we knew it.
In the early 80s, Dr. Binder was the first to use computer technology to engineer curves in the molds to make implants. "We actually used technology from the aerospace industry to make better and more anatomically reasonable facial implants." After that, he was the first to use 3-dimensional computer modeling and computer technology to make custom implants for facial reconstruction.
At the time, facial implants for reconstruction and cosmetic reasons were a long process that involved bone grafts taken from donor sites such as the hip or rib or titanium plates to re-establish bone formation and were often secured in place with screws. Dr. Binder states, "Bone grafts, by large, are unpredictable. The reabsorb or the screws can get infected. And usually, you get shrinkage, unpredictability and you never really get the right end result that you want, particularly over time."
Customized Facial Implant Results of Dr. William J. Binder
Severe Soft Tissue Defects Reconstructed With Midface and Mandibular Implants
By using 3-D imaging software and CT scans, Dr. Binder's new process helps patients save time and money and with more accurate results. "After a CT scan, data is then reformatted into a 3 dimensional computer image. The imaging is then reformatted with a technology that produces a plastic model of the patient's skull. Now you can hold the patient's facial skeletal or bone structure in your hand. You can see size, the difference between the sides, you can rotate it in space and look at it from every angle and see the deficiencies. It now becomes exponential in terms of your ability to see the difference between the two sides."
Where there is a defect in the skull, Dr. Binder says, "We fill the defect in with modeling clay, in the beginning we just used wax, and then we take that piece out and and a silicone implant is made to replicate that missing piece. Now then the implant is sent back to us and what would have taken a 3 or 4 hospitalized procedure was done in an outpatient basis in less than an hour."
Customized Facial Implant Results of Dr. William J. Binder
Defect of Forehead, Reconstructed with use of a Custom Implant.
After the silicone implant is created, it is sent back to Dr. Binder, "Once you get the implant, you put it on the plastic model of the skull, and the implant snaps into place like it actually belongs there." By matching up the the existing bone in the skull to the implant, similar to putting a cap on a tooth, Dr. Binder effectively eliminates the need for screws, "In 98% of these cases, I don't need to use screws, which increases the trauma of the surgery and manipulation of the tissues. I don't have to use any type of fixation device."
By doing the majority of the planning for the implant with the model of the patient's skull from the CT scan, Dr. Binder greatly reduces the time and expenses in the OR. Much of the guesswork that went into traditional facial implants has been eliminated, thus creating a more accurate and customized facial implant.
