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The art of alloplastic implant procedures

Article-The art of alloplastic implant procedures

Indian Wells, Calif. — Facial contouring with alloplastic implants can be a fine balance between artistic interpretation and surgical precision.

A male patient is shown before and after an implant procedure. Because implants often must be customized, Dr. Terino prefers a silicone rubber device.
With proper vision and skill, post-operative results can be amazing. Such results have been achieved by cosmetic surgeons who have followed the lead of facial sculpting pioneer Edward O. Terino, M.D.,of Thousand Oaks, Calif. Recently, he offered hisexpertise and insights into facial revision using alloplastic implants at a one-day seminar, "Sculpting Faces 2005," here.

"What I developed here was an art form," he tells Cosmetic Surgery Times. "A way of shaping faces that is going to be and is becoming in very great demand. It is unbelievable what you can do with these implants, in addition to other surgeries."

Growing demand for beauty In his years of experience, Dr. Terino has found complications resulting from implant surgery to be rare. While infection and nerve damage can be real possibilities, he feels that surgeons who knowthe operation and have ample skill should not encounter such complications.

"Technically, they are not difficult procedures," he says. "They are much easier to perform than a standard facelift or even a breast implant operation."

A female patient is shown before and after receiving an implant. Implant procedures require the surgeon to analyze the face to see where it can be improved by adding volume and shape.
The challenge, according to Dr. Terino, is thoroughly understanding the patient's desired outcome and then creating that look using alloplastic implants that give the face a natural beauty. Often, the implant must be customized, and that is oneof the reasons why Dr. Terino prefers a siliconerubber implant.

"It goes in easily, is flexible and can be taken out and changed easily," he says. "It is held in place by the body forming scar tissue around it."

The margins of silicone rubber implants can be tapered to blend with natural facial contours, making the implant less noticeable.

Technology-aided art Implant procedures "require artistic perception of the face — analyzing where a face can be made better by adding volume and shape to it, and where it cannot," he explains. "A giant nose and small chin, anyone can figure out what is wrong and how to improve. A lot of this is more subtle."

To address the nuances of a patient's post-operative face, Dr. Terino says computer imaging allows him to show patients how implants will change and enhance their appearance.

"Without computer imaging, you are dead in the water. Patients are trying to tell you what they want, but they can't see it."

Having used computer imaging for eight years, he considers the technology to be "indispensable" because he can "take a patient's face, change the cheeks, chin or shape of a face right before their very eyes."

According to Dr. Terino, a surgeon can do so much more for the face using implants. Anatomic style implants are commerically available for mid-face premandible and premaxillary modifications.
However, he concedes that the large financial investment and lengthy learning curve associated with such technology are significant hurdles for most cosmeticsurgeons.

Shift in thinking While standard facial rejuvenation techniques are two dimensional, facial sculpting with alloplastic implants addresses the third dimension and does so better than injectables, which Dr. Terino considers to be less precise and less durable than implants.

"Without implants, plastic surgery is very limited," Dr. Terino says. "Tightening procedures are two-dimensional. Faces are three-dimensional."

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