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Facial Masculinization Surgery Using Polyetheretherketone Alloplasty: Statistical Shape Modeling-based Implant

Hylke van der Wel1, Bram J Merema1, Joep Kraeima1

  • 1From the Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.

Plastic and Reconstructive Surgery. Global Open
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Summary

This study developed a 3D statistical shape model of male skulls to guide facial feminization surgery. This method aids in designing patient-specific implants for facial bone augmentation, improving surgical outcomes.

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Area of Science:

  • Maxillofacial Surgery
  • 3D Medical Imaging
  • Biomechanical Engineering

Background:

  • Facial features are key in gender perception and can cause gender dysphoria.
  • Surgical facial masculinization aims to alter the bony framework for non-cisgender males.
  • Patient-specific polyetheretherketone (PEEK) implants are increasingly used in maxillofacial augmentation.

Purpose of the Study:

  • To develop a 3D statistical shape model of male skulls for surgical planning.
  • To identify key regions of gender dimorphism in the male skull.
  • To virtually design patient-specific augmentation implants using the developed model.

Main Methods:

  • A 3D statistical shape model was created from 40 male patient skull datasets.
  • The model captured mean shape and principal components of shape variation.
  • This template was overlaid onto patient 3D skull models to identify dimorphic regions.

Main Results:

  • The method identified the orbital ridge, zygomatic regions, and frontal bossing as key areas of gender dimorphism.
  • Virtual design of polyetheretherketone implants was performed based on the 3D template overlay.
  • The process allowed for patient-specific augmentation planning.

Conclusions:

  • A 3D statistical shape model provides an objective reference for maxillofacial augmentation.
  • This approach facilitates patient-specific implant design for facial masculinization.
  • The method enhances patient involvement in treatment planning for gender-affirming surgery.