Definition and Overview
A facial prosthetic is a device that is attached to the face and, to a certain extent, to the head, scalp, and mouth, to restore the form and function of the missing or deformed body part.
A person who specializes in making this device is called a clinical anaplastologist. In certain areas such as the UK, they are known as maxillofacial prosthetists and technologists. Sometimes, those who specialize in maxillofacial prosthodontics such as the attachment of dental implants can also be called anasplastologist. The distinction is much clearer in countries where these professionals are aplenty and are significantly varied.
Anaplastology is a non-physician job, which means that anaplastologists do not go through as many years of training as specialty doctors. However, they still have significant background and education in medicine, primarily in biology. They are also expected to participate in regular trainings and continuing education, especially since new techniques are introduced on a regular basis.
Facial prostheses have been used for several decades particularly in the entertainment industry. The techniques adopted for medicine are not significantly different. However, a medical-related facial prosthetic device is more reconstructive than cosmetic, and as such, it’s often covered by medical insurance. The creation of this prosthesis requires the expertise of surgeon and anaplastologist, and the patient’s full participation.
Who Should Undergo and Expected Results
A facial prosthetic device is recommended if:
A facial prosthetic is a better option than surgery – Usually, the first option for patients with deformed facial parts is surgery. For example, if the face is badly burned, skin graft becomes an option, wherein the healthy skin is removed from a certain area of the body and then transplanted to the face. However, in certain cases, this may not be possible, such as if there’s not enough skin for grafting. The next best step is to advise the patient to wear facial prosthetics.
The person suffers from the effects of physical trauma – Accidents and other types of physical injuries can lead to the deformation or loss of facial parts such as the eyes or nose, for example. The prostheses can then be worn to restore the appearance of the face.
The face is deformed due to a medical condition – These conditions can be congenital or a result of a disease. A good example is when tumors develop on any part of the face, or a person suffers from skin cancer. In skin cancer, the first step is usually to remove as much cancer as possible. In the process, this may leave multiple scars, sometimes, huge ones, on the face. A tumor, meanwhile, can leave hollowed sections and may also lead to the removal of the ears.
The patient is unwilling to undergo surgery – For those who are still concerned about undergoing surgery due to possible risks and complications, they may opt to wear prostheses for a while.
These days, anaplastologists are able to create facial prostheses that look very natural. 3D printing, one of the newest innovative techniques in medicine, can produce accurate-looking prosthetics. However, although prostheses can help improve the function and form of the diseased or missing body part, it cannot completely be used as a substitute.
Nevertheless, facial prosthetic devices can significantly help in improving the overall appearance, increasing the level of confidence of the patient, and giving them opportunities to live more independently and become more mobile.
How Does the Procedure Work?
Creating a facial prosthetic device is a collaborative effort. It begins with the patient’s doctor, who can give the best advice on what type of prosthetic the patient needs. It is also his responsibility to determine whether the patient is eligible for such.
An anaplastologist will then start working on the prostheses. He may use computer-aided guides or obtain a mold of the deformed or missing body part. Different materials can be used to create the prostheses, but the choice will always depend on what best fits the texture and color of the patient’s skin, as well as the level of comfort and possible risks and complications once worn. These molds will then be sent to the lab where the prosthesis will be made.
The patient then returns for fitting and attachment. The prostheses are normally attached externally, which means they can be removed at the end of the day. In certain cases, however, they are bonded to the skin tissue using a health-grade adhesive or through osseointegration, in which an implant is attached to the bone and serves as the “holder” for the prostheses.
Possible Risks and Complications
Prostheses have fewer serious risks and complications than surgeries, which make them more appealing than the latter. Nevertheless, they also have certain challenges. These include the fact that prosthetic devices don’t last forever. Usually, they can only be used within three to five years, and they require regular care. They may also have to be adjusted on a regular basis.
Also, patients may be left with an ill-fitting device—like one that moves—or allergies, but these will only occur if the anasplastologist isn’t experienced, the patient fails to cooperate during the process, or the doctor has skipped certain steps like asking the patient if he is allergic to the materials used for the prosthetic.
Mayersak RJ. Facial trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby Elsevier; 2013:chap 42.
Hill JD, Hamilton III GS. Facial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 22.