Atlas of FACIAL IMPLANTS

Atlas of FACIAL IMPLANTS
Copyright
Preface
Acknowledgments
Dedication
1 - Indications for facial implants
Facial Balance and Definition
Skeletal deficiency
Fig. 1.5 shows a patient with corrected occlusion who underwent multiple implant correction of her midface and mandibular defici...
Congenital deformities
Posttraumatic and postablative deformities
Skeletal versus soft tissue augmentation
2 - Evaluation and planning for facial implant surgery
Radiologic Examination
Facial Measurements
Mathematical ideals
Facial anthropometrics
Sexual dimorphism
3 - Implant materials
Autogenous materials
Bone
Factors that impact result
Graft architecture and revascularization
Rigid fixation
Recipient site
Cartilage
Fat
Alloplastic materials
Metals
Polymers
Polysiloxane (silicone)
Polytetrafluoroethylene
Acrylic
Polyethylene
Polymethylmethacrylate–polyhydroxyethylmethacrylate
Polyether ether ketone
Ceramics
Hydroxyapatite
Senior Author’s Preferred Implant Materials
Morbidity and complications associated with alloplastic implants
General considerations
Carcinogenicity and systemic disease
Hypersensitivity
Specific implant complications
Studies assessing polymeric and ceramic implants at mixed sites
Limitations of clinical series
Personal experience with porous polyethylene implants
4 - Principles and operative technique for facial skeletal augmentation
Preparation
Anesthesia
Incisions
Exposure
Implant Selection
Screw fixation
Hemostasis
Personal experience
5 - Cranioplasty
Skull Anthropometry
Cranioplasty for Full-Thickness Defects
Indications
Timing of surgery
Materials
Implant fabrication at the time of surgery
Hydroxyapatite
Titanium mesh
Prefabricated implants: CAD/CAM
Lag screw fixation
Intracranial drain access
Functional Cranioplasty
Drug-resistant epilepsy
Shunt mechanism
Cranioplasty for Contour Irregularities
6 - Temporal augmentation
Etiology of Temporal Hollowing
Treatment Options
Operative Technique: Aesthetic Temporal Augmentation
Access
Formation of submuscular pocket
Shaping the implant
Clinical example
Operative Technique: Postsurgical Temporal Muscle Violation
Access
Temporalis muscle reattachment
Implant placement and immobilization
Clinical example
Personal Experience
7 - Internal orbit
Orbital Anatomy
Preoperative Evaluation
Physical examination
Radiologic imaging
Operative Technique
Timing
Exposure
Mobilization and retrieval of orbital contents
Internal orbit reconstruction
Implant materials
Clinical Examples
8 - Infraorbital rim
Globe–Rim Relations
Jelks’ vector analysis
Altering Globe–Rim Relations: Reversing the “Negative Vector”
Blepharoplasty
After blepharoplasty
Graves’ disease
Surgical Anatomy (fig. 8.4)
Preoperative Evaluation
The Implant
Operative Technique to Augment the Infraorbital Rim
Primary surgery
Post-blepharoplasty lower lid retraction
9 - Malar
Preoperative Planning
Anthropometric data
Subjective analyses
Surgical Anatomy
Skeleton
Muscles
Sensory nerves
Implant Design
Operative Technique – Primary Surgery
Operative Technique – Secondary Surgery
10 - Pyriform aperture
Surgical anatomy (fig. 10.3)
The Implant
Operative Technique (fig. 10.5)
Clinical Examples
Nasal Implants
11 - Chin
Evaluation and Planning
Physical examination
X-rays
Anthropometric data
Sagittal projection (profile)
Lip–chin relations
Labiomental angle
Subjective criteria
Vertical projection (height)
Horizontal projection (chin width)
Predicting the soft tissue response to skeletal augmentation
Surgical Anatomy
Mental nerve
Mentalis muscle
The Implant
Preferred Operative Technique
Anesthesia
Submental incision
Implant positioning
Screw fixation
Submental lipectomy
Clinical examples
Skeletal Asymmetries
Secondary Surgery
Mentalis muscle damage
Implant-related deformity
Sliding Genioplasty
After sliding genioplasty
12 - Mandible
Indications
Normal dimensions
Skeletal deficiency
Surgically altered anatomy
Evaluation and Planning
Physical examination
X-rays
Surgical Anatomy (Fig. 12.5)
Skeleton
Musculature
Inferior alveolar nerve
Implant Design
Operative Technique
Anesthesia
Incisions
Implant positioning and fixation
Pterygomasseteric sling disruption and repair
Clinical Examples
13 - Rejuvenation of the aging face and skeleton with implants
Soft Tissue Aging
Facial Skeleton Aging
The Aging Orbital Skeleton
The Aging Midfacial Skeleton
The Aging Lower Facial Skeleton
Delaying Skeletal Senescence
14 - Designer faces: CAD/CAM facial implants
Indications for and Advantages of Cad/Cam
Implant Development
Personal Design Technique
15 - Implant refinement of postorthognathic surgery facial contour
Midface Contour Irregularity
Lower Face Contour Irregularity
Implant Refinement
Cad/Cam Implants
Implant design
Upper face
Lower face
Surgical Technique
Upper face
Lower face
Patient Examples