Testimonials

CT designed (Bespoke) Facial Implants

Dr. Yaremchuk has innovated the use of custom facial implants for both aesthetic and reconstructive indications. Precise measurements obtained from CT scans allow creation of physical models that allow Dr. Yaremchuk to design implants unique for the patient. These Computer Aided Designed (CAD) and Computer Aided Manufactured (CAM) or CAD/CAM implants are especially useful for patients with significant asymmetry and for patients who have had orthognathic surgery and are left with noticeable contour irregularities. 

3D CT scans can be obtained on the day of consultation with Dr. Yaremchuk. The three dimensional image reveals the exact underlying skeletal anatomy of the patient. Since one's facial skeleton is the fundamental determinant of their appearance, it can be invaluable to patient understanding during the consultation.

Of course, it makes surgical planning more precise when using both custom and off-the-shelf implants. The CT scan that can be obtained on the day of consultation is obtained from a new technical modality referred to as Cone Beam CT (CBCT). In layman's terms, CBCT is a compact, faster and safer version of the regular CT. Through the use of a cone shaped X-Ray beam, the size of the scanner, radiation dosage and time needed for scanning are all dramatically reduced.

A typical CBCT scanner is easily accessible by patients. The time needed for a full scan is typically under one minute and the radiation dosage can be up to a hundred times less than that of a regular CT scanner.

To see an example of how the CBCT images help patients visualize their “after” surgery appearance, click here.

Below are img 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 below image on the left shows the patient's underlying skeleton. The image on the right shows the the custom made bespoke implants overlying her native skeleton.

 

 skeleton_facial_implant

 

The patient below underwent custom implant reconstruction of her mandible to correct irregularities and deficiencies of her mandible resulting after sagittal split osteotomy. To see a video of her surgery click here.

implant

 

This patient with hemifacial microsomia had been treated with sagittal split osteotomy, horizontal chin osteotomy and later distraction osteogenesis in attempts to reconstruct a symmetric mandible.

CT designed custom implants were used to result in this improvement.

implant2

 

This patient had custom implants placed to augment his deficient chin and mandible.

implant3

 

This patient had undergone mandible angle reduction in the past. She disliked the new look and desired restoration of her angles.

Custom implants were designed to restore angles which provided the desired lower face width.

implant4