What is Clinical Anaplastology?

Clinical anaplastology is the area of medicine that deals the with prosthetic restoration or rehabilitation of a malformed or absent area of the face or body. Unlike prosthetists, anaplastologists don’t make limb prosthetics, though they do create prosthetic fingers, toes, feet, hands, breast prostheses (called somato prostheses). Anaplastologsits create several types of facial prosthetics including auricular (ear), nasal (nose), ocular (eyeball), orbital (the eyelids, sockets, and surrounding area), and midfacial (the nose and significant tissue extending from it which may include the cheek or orbit). It’s an important area of work that can have life-changing effects for patients, improving function, appearance, and overall wellbeing.

To create a life-like facial or somato prosthesis, the area must be sculpted to visually match and physically fit the patient’s existing anatomy. The finished sculpture is then molded and cast in silicone. It is custom colored to match the patient’s skin. Anaplastologisists aim to capture even the tiniest details including blood vessels, hair, and freckles. Additional anatomy such as eyes and nails can be made from other materials.

Wax Sculpting an Orbital Prosthesis with a little help from CAD/CAM Technology

We’ve been working with some different technologies over in the Craniofacial Center to create orbital prostheses. In this case, we used a Cone Beam (CB) CT scan of the patient’s orbit, which we segmented out in Mimics. We then manipulated the data in 3D Studio Max and Rhinoceros to get it sized and oriented properly for rapid prototyping using subtractive 3D printing and a CNC Mill in hard wax. From there we created a silicone mold in RTV 3110 Silicone (which is my new favorite duplicating material) and made a clinical wax positive to finish. Our data wasn’t ideal (for example, the eye was closed, some scattering of the CB CT Data created distortions in the mold of the superior bony orbital) but it was still a promising workflow and I could see where it could help speed production along in some cases.

We are also using photogrammetry to create nasal prostheses. Photogrammetry is amazing. More about that later. Enjoy!

Orbital Prosthesis, Clinical Wax Sculpt