• MIRAI 3D

Facial reconstruction with 3D mask for burn patient

Dr. Hernán Aguilar & Dr. Horacio Mayer


Hospital Italiano - Buenos Aires, Argentina


Benefits

Adapts to the irregular shape of each patient's face.

Adequately immobilises the skin grafts, while at the same time allowing

the growth of new vessels

Applies even pressure to the grafts

Prevents hypertrophic and pigmented scars

Obtain optimal functional results from grafts.

Improves success rate and postoperative status

Start of surgical procedures earlier than in a traditional procedure.


Clinical case

38-year-old man suffered third-degree burns over 40% of his body from an exploding car cylinder. Extensive facial damage included forehead, eyelids, nasal region and both cheeks.





3D Mask

FDM technology

Material: PLA

Resolution: 0.2 mm

Finish: One colors





Surgical plan and results in the operating room


To perform the facial reconstruction, the plastic surgeons decided to use a customised mask that would favour the procedure and the postoperative period of the patient in question.


This mask was printed in a 100% biodegradable polymer, derived from lactic acid, which has a low risk of causing allergic reactions.


To do this, they performed a sequence of steps:


  1. After removing the dead tissue from the patient's face, a scan of the patient's face was performed using non-contact simulation software.

  2. From the data of the face scan, the virtual personalised mask was created using design software and a printable file was obtained.

  3. The mask is 3D printed. The design included lateral openings on both sides so that it could be adjusted to the patient's face with elastic bands.

  4. Between the second and third week after the patient was admitted, the grafts were placed on the eyelids and artificial dermis on the patient's face. The 3D mask (previously sterilised) was then placed on the patient and adjusted with elastic bands. It was kept in place for 7 days to ensure proper integration without the need to remove it for meals and oral hygiene.

  5. One week later, the skin grafts were placed on the correctly integrated artificial dermis and the mask was placed again to immobilise the grafts for a further week.

  6. One week after the final procedure, the mask was removed and the full integration and vitality of all tissues was verified.

  7. Postoperatively, pressure therapy was indicated with the same customised mask in which the patient had to wear it for at least 20 hours per day. The treatment was well tolerated and no complications were encountered.

After 6 months, an optimal facial scar with an acceptable skin colour is obtained and functional and aesthetic sequelae are avoided.

The use of the customised 3D mask for one year allowed the scars to continue to shape and improve their appearance: colour, texture and volume.


Published paper: A new method for securing dermal substitutes and skin grafts to difficult portions of the face using a custom 3D-printed facemask - Hernán A. Aguilar and Horacio F. Mayer, MD, FACS