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Application of 3D Cutting Guide in Facial Contouring Surgery

Dr. Ming-Chi Hsieh uses 3D printing technology extensively on various kinds of craniofacial surgery procedures. Here we give a brief introduction of 3D printing application in 3D cutting guide.
 

Why need "3D navigation powered 3D cutting guide"?
Most people do not understand that facial bone reduction is extremely challenging even to the most experienced surgeon. During surgery, the exposure of operative field is very little and the surgeon can neither see clearly the full surgical site nor identify the relative position to the whole face.
 

3D cutting guides are powered by 3D navigation system, which allows the surgeons to perform bone resection as planned.
 

With the assistance of 3D navigation powered cutting guide, the surgeon can accurately perform bone resection through cutting guide defining the desired resection plane so as to achieve excellent results and avoid complications, such as enhancing symmetry and proportionality while preventing injury to inferior alveolar nerve.
 

Poor surgical outcomes resulting from lack of the assistance of 3D cutting guides
(domestic and overseas case examples)  

Case 1
This is a clear example of poor bone reduction surgical result, showing an unsmooth, unnatural and disproportionate jaw contour. This was because first the surgeon did not take the whole face shape into consideration while making surgical planning; second the surgeon could not identify the relative position of the jaw to the whole face while performing the surgery due to the lack of 3D navigation application.  
 

Case 2
This is an example of too much bone got shaved off during surgery, showing an asymmetric face shape and the surgical site (marked by dashed circle) too close to eyes that put the patient at high risk of vision loss. Apart from pursuing ultimate aesthetic enhancement, surgeons should have a thorough understanding and knowledge and pay close attention to the intricate anatomy of the face to avoid complications (possible eye damage in this case).
 

3D navigation powered cutting guide
The 3D cutting guide shown in the figure can guide the surgeons to perform bone resection as planed. Before surgery, the surgeons use sophisticated 3D navigation system to compute the optimal resection area and create a patient-specific 3D cutting guide. During surgery, the 3D cutting guide was used to achieve symmetry and improve safety of the patients.