How is a prosthesis made?
In general, facial and somatic (body) prostheses are created by reproducing a three-dimensional model of the absent anatomy by one or a combination of methods, such as traditional sculpting, virtual sculpting, computer-aided design, and generating a 3D-printed prototype. Careful observation is used to reproduce accurate anatomical form and surface textures. The anaplastologist also employs color matching techniques to mimic those found in the patient's skin. A mold is created based on the prosthesis sculpture, and pigmented silicone is carefully applied to the mold according to a customized color pattern that will yield a highly realistic similarity to that of the patient's skin coloration. The resulting silicone prosthesis should appear to blend with the patient's tissue surface and restore the absent or affected anatomy.
How is a prosthesis "held on"?
Prostheses are not permanently attached to the patient. Prostheses may be retained using medical-grade adhesives (glues), or by attaching to osseointegrated ("bone-anchored") implants. These implants are small titanium screws fixed within bone. Implant-retained prostheses use clips or magnets disguised within the prosthesis to provide reliable placement and retention.
Belgium-based anaplastologist, Ali Padilla, shares steps in making a prosthesis
(Left) Tissue surface where ear anatomy is missing; bar retention system positioned over osseointegrated implants (titanium screwed fixed within the bone)
(Middle) 3d-printed model of donor ear used to determine final ear shape
(Right) Wax sculpture used to create a mold for the final silicone prosthesis. Fine textural details are sculpted into the wax to create the illusion of skin texture in the silicone prosthesis.
In most particle hand/foot cases, and some facial cases, the remaining contours of the patients tissue surface will allow for anatomical retention of a prosthesis, and the prosthesis is designed so that it can be held in place by mechanically engaging with the remaining anatomy, requiring no additional adhesive or implants.
The ideal retention method is dependent on each patient's specific circumstance and needs.
(Left) tissue surface without prosthesis
(Right) Implant-retained silicone prosthesis attached by bar-and-clip retention system
Follow our posts throughout Anaplastology Awareness Month to learn more Color Matching and Painting a Prosthesis!
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See more prosthetic cases by Ali Padilla at oxenfreeart.com