A person may be missing a portion of the face due to a congenital or acquired condition. A congenital condition is one that you are born with; such as a facial cleft or hemifacial microsomia. An acquired condition exists as the result of facial injury (trauma) or due to surgery to remove a tumor. An ear, eye, or the nose may be affected. In any case, this may affect the way you look or function.
For many facial conditions, surgical reconstruction is the most natural way to restore appearance and normal function. However, such reconstructive surgery is not always possible or desirable. In such cases, a facial prosthesis may be an alternative treatment.
A facial prosthesis is an artificial replacement of an eye, ear, nose or other portion of the face that restores normal appearance may improve function. The prosthesis is made of medical grade silicone rubber and is custom made to suit the fit and appearance of the individual patient. Fabrication is a simple and painless procedure that requires 5-7 office visits to complete.
Once you and your maxillofacial prosthodontist determine that a facial prosthesis is the best treatment for you, fabrication begins. At the first visit, an impression or mold is made of your face. Then plaster is poured into this mold to make a model of your face. At the next visit, a prototype of the prosthesis is sculpted in wax to determine the right size, shape, and position. In the case of an acquired condition, you may be asked to bring in photographs of yourself before the accident or surgery to use as sculpting references. Sometimes it may require more than one visit to complete the sculpting process.
Next a color formula of your skin is determined that will make your prosthesis appear lifelike and blend in with your natural skin color. Then a plaster mold is made of the wax form, the wax is melted away, and silicone rubber of various skin colors are painted and poured into the mold to make the prosthesis. The closed mold is placed in a special laboratory oven so that the silicone can be processed into a soft, rubbery consistency.
The prosthesis may be held in place with special skin glues or attachments that are connected to small titanium screws or implants that have been placed into the bone around the effected facial area. You and your maxillofacial prosthodontist will determine which method of retention is best for you.
When you receive the prosthesis, your doctor will give you detailed instructions as to how to put the prosthesis on and take it off. They will also instruct you on how to keep the prosthesis clean and how to care for the skin under and around the prosthesis. Usually, the prosthesis is kept clean by gently brushing it with a soft toothbrush and mild soap and water. The skin should be cleaned daily with soap and water, too. If you decide to have the titanium implants to hold your prosthesis in place, they will require a little extra time and effort to brush around them gently with a soft brush to keep them clean and the surrounding skin healthy. These simple procedures should be performed at least once a day (usually at bedtime) to maintain the health of the skin and to keep the prosthesis looking good and fitting well. The prosthesis should be removed for sleep.
These documents and links are intended to inform you of issues, sequelae, and treatment options related to various diagnoses and maxillofacial prosthodontic treatments that may interest you. The information is not intended to suggest or dictate treatment or outcomes, but may serve to begin a discussion with your physician and prosthodontist.