Facial Implants

Dr. Yaremchuk employs his knowledge and experience with craniofacial surgery and biomaterials to create new facial skeletal contours. Using facial implants he can mimic the facial appearance obtained with more extensive facial skeletal surgeries. Dr. Yaremchuk custom carves all facial implants from basic shapes - many of which he has personally designed.

These procedures can be done on an out-patient basis. Click for an overview of how facial skeletal augmentation can mimic the appearance obtained with skeletal osteotomies.

 

Implants are available to augment all areas of the face including:

 

As an expert on altering the facial skeleton for cosmetic and reconstructive purposes, Dr. Yaremchuk lectures nationally and internationally and has written several book chapters and scientific articles on these topics. His book, "Atlas of Facial Implants", was awarded an Association of Medical Illustrators Award for surgical atlases. Scientific articles published in 2011 address the use of facial implants both for facial rejuvenation, and also as adjuncts or alternatives to orthognathic surgery. These include "Alloplastic Augmentation of the Facial Skeleton: An Occasional Adjunct or Alternative to Orthognathic Surgery" and "Aging of the Facial Skeleton: Aesthetic Implications and Rejuvenation Strategies."

As a testament to Dr. Yaremchuk's extensive expertise in this area, Matrix Surgical, an international manufacturer and distributor of plastic surgery products, signed a licensing agreement to manufacture and distribute his patented innovative facial implants in spring 2014.

 

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This patient desired several changes in his facial contour. In two operations, Dr. Yaremchuk performed infraorbital rim (lower eye socket), paranasal (bones lateral to the nose), malar (cheekbone), and mandibular body (lower jaw) augmentation. In addition, the patient had a midface lift, lateral canthopexy (to change the shape of his eyes), and rhinoplasty.

 

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 virtual and 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
  • patients with significant asymmetries
  • patients are unhappy with prior skeletal reduction and desire skeletal restoration
  • patients who desire the best possible result made possible by unlimited design variation and perfect implant fit

If requested when scheduling,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.The 3DCT makes surgical planning more precise when using both custom and off-the-shelf implants.

Below are planning images derived from a CT 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.

 

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Below is transition showing the impact of the skeletal alteration on her appearance.

 

 

Patients who have had orthognathic surgery and are left with noticeable contour irregularities.

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.

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Below is transition showing the impact of the skeletal alteration on her appearance. Note how the implants created a pleasing jawline. The sagittal split osteotomy was intended to improve her bite by expanding her deficient skeleton. After the sagittal split and skeletal rearrangement her bite was satisfactory. However, since no bone was added to her mandible, it was still deficient, but in a different way. The deficiency was manifest by a weak jawline and loss of her mandible angles.

 

 

Significant Asymmetry

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.

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Patients who desire the best possible result made possible by unlimited design variation and perfect implant fit

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

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Patients are unhappy with prior skeletal reduction and desire skeletal restoration

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.

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