Facial Prosthesis: Oportunities for a normal life

Author:
Dr. MANUEL ALBERTO BURBANO S.
Maxillofacial Surgery.
Oral & Maxillofacial Implantology
Facial Prosthetics
American Anaplastology Association

What is a prosthesis?

A prosthesis is defined as any structure implanted in an organism which purpose is to correct an injury or a malformation, and to restore patient’s normal functions.

Use of facial prostheses can be dated from ancient times, as found in egiptian mummies with artificial noses and ears, or with stone or mosaic eyes.

Ambrosio Paré is considered a relevant figure in facial prosthesis development during XVI century. LAter, Pierre Fouchard, Kasanjian and Converse develope several advances, setting bases for many other developments.

Craniofacial Implants and Implant-retained ear prosthesis

In Germany, prostheses are called Epitheses, from greek "epithema" which means "to put something on top" in order to conceal an abnormality.

Somato-prosthesis, Facial Prosthesis or Epithesis are general terms found in literature. Nowadays, tendence is to name prostheses according to the area they are located on.

Classificación of Prostheses

According to the area where a prostheses are applied, they can be cassified as:

  • Auricular (ear pavillion)
  • Ocular (eye)
  • Orbit-ocular (eye orbit)
  • Nasal (nose)
  • Complex (Orbit-Nasal, Nasal-Maxillary)
  • Cranial
  • Maxillary
  • Mandibular

Depending on the form of retention (attachment), there are other classifications:

  • Implant retained
  • Adhesive
  • Energized or Magnet-retained
  • Mixed
  • Attached to personal objects (glasses)

What are the uses of facial prostheses?

Prostheses are used to restore function and/or appearance in patients who have suffered injuries or deformities, which can be caused by three main factors:

Nose cancer - Craniofacial implant - retained prosthesis

a. Congenital Defects, specially associated to craniofacial syndromes, e.g. Treacher Collins, Hemifacial Microsomia, where localized defects  on ear pavillion, microtia, or total absence of ear pavillion (one or both sides) can be found. Also, Congenital Anoftalmia, which is a defect associated to other pathologies.

b. Trauma: Specially caused by high energy impacts, car accidents, fire weapons, or physical aggression, tearings or bites on ear or nose areas.

c. Neoplasy: Large extension benign tumors on maxillary bones, which require safety margins in order to avoid recurrence, e.g. upper maxillary myxoma, palate pleomorphic adenoma, and malign maxillary lesions, adenocarcinoma, maxillary sinus cancer, among many others, and malign dermatological lesions located on nose, ear pavillion, face skin and eyelid area, which, when resected, leave big injuries taht can not be reconstructed by using grafts.

Main goal of facial prosthesis is always to provide integral rehabilitation to patients, in order to ease their return to a normal life and human interaction.

Permanent creation and evolution of materials used in prosthetics, such as silicones and pigments, and the improvement of craniofacial implantology allow us, nowadays, to offer more anatomically correct, comfortable prostheses to patients.