Nov 13, 2015
A young man has had his face totally reconstructed after an altercation left his cheekbone and lower eye socket completely crushed. A 3D printed model of the patient’s skull was used by plastic surgeon Daniel Borsuk to help carve a cheek implant from the patient’s hip bone.
People tend to have mixed opinions about cosmetic surgery. Whilst the obsession with surgical procedures amongst Hollywood celebrities can seem shocking and bizarre, cosmetic surgery can also be used to give a normal life to those born with abnormalities or who have suffered severe injuries. Alex, the young man on whom Dr. Borsuk operated, falls into the latter category. Aged 19, the youth received a severe beating, causing severe damage to one side of his face. The crushed bone gave his face a lopsided look, causing the teen much distress.
Now 23, Alex had several operations to try and fix his face. All surgeries failed, with one causing a dangerous infection and almost ruining the young man’s life. That disastrous attempt caused pus to ooze out of one of Alex’s eyelids for almost a year. The infection caused endless pain for the poor patient, who needed antibiotics and developed a dangerous dependency on painkillers.
Despite his faith in cosmetic surgery being almost destroyed, Alex kept thinking about one particular case which had caught his attention. In 2012, a man whose face had been massively disfigured by a gunshot wound was given an entirely new facial bone structure, over which a new face was attached. That procedure was led by Eduardo Rodriguez, with Canadian Dr. Borsuk also part of the team. Alex sought the help of Dr. Borsuk to see if there was anything that could be done.
When the surgeon asked Alex how the trauma had affected his life, both the patient and his mother started crying. “He said, ‘You have to do anything you can to fix this,’” recalled Dr. Borsuk, who was determined to oblige and reinstate Alex’s lost self esteem. “A lot of my patients don’t leave home. They shy away from society and many lose their jobs because they don’t want to go to work and be seen by people who knew them before.”
The next step was to figure out just how the problem could be remedied. Dr. Borsuk decided that a foreign object or bone graft would be too risky, given the chances of infection—given Alex’s awful past experience with that particular outcome, it was never a chance worth taking. Dr. Borsuk decided that the best solution would be to take a small piece of bone from Alex’s hip, still attached to vein and artery, and chisel that piece of bone into a new piece of cheekbone. As unbelievable as the technique sounds, it proved a huge success. “We keep the artery and the vein with the piece of bone that we have,” explained Dr. Borsuk. “That’s going to make the piece of bone heal like it’s a normal piece from your body, that heals within three to six weeks.”
3D printing was used to successfully aid Dr. Borsuk’s work. A 3D scan was taken of Alex’s skull, which was then 3D printed. A mirror image of the undamaged side of Alex’s skull was used to figure out how the missing pieces of the damaged side should look. “We printed out a 3D modelled skull, and a model of what’s different between the left side and the right side,” the surgeon explained.
The operation itself took around eight hours, during which Dr. Borsuk carved at the small piece of hip bone, using the 3D printed model implant as a guide. “There was blood going in and out of the bone, keeping the little implant alive while I sculpted it to fit his face,” said Dr. Borsuk. “We went in and cleared off all the scar tissue that was causing him pain, we cleaned off where the nerve was … when we passed the bone, it clicked on like a puzzle.”
After numerous previous procedures which had left his face looking even worse than before, Alex had one important request for Borsuk and his team. “He asked if there was a way to return his face back to the way it was before, without adding any scars to his face,” recalled Dr. Borsuk. “So, through using some of our new techniques [like] virtual surgery, 3D printing and some novel surgical techniques, we are able to actually give him what he wanted… We did this through an incision within the mouth. Then we had to reattach the artery and the vein to an artery and vein that we found inside his cheek.”
Dr. Borsuk’s skill, with the help afforded by 3D printing, has saved Alex and given him his old life back. “Three weeks after the surgery, he’s doing very well,” the surgeon explained. “The chronic pain he’s had in the past has almost completely subsided. He doesn’t have any infections and he looks more or less the way he looked before he had the trauma… Once the swelling goes away, we shouldn’t be able to tell the difference.”
In the past, this type of procedure would have necessitated multiple interventions and left one or more scars.
“The operation, during which the latest technologies were applied to reconstructive plastic surgery, sends a real message of hope to anyone who feels they must simply live with this type of disfigurement and who often feels so self-conscious that they isolate themselves,” Dr. Borsuk added.
The medical possibilities opened up by 3D printing continue to save lives and restore self esteem around the globe. We wish Alex a speedy recovery and encourage Dr. Borsuk to continue his good work.
Alex, before the trauma (above) and after the surgery.