Three-dimensional printing of facial contour based on preoperative computer simulation and its clinical application

Facial contouring is a complex procedure performed to alter tissue contents and restore facial appearance. However, it is difficult to measure the amount of the tissue volume that is needed. This study demonstrated the use of preoperative computer simulation (PCS) and 3-dimensional (3D) printing in contouring procedure to maximize outcomes. Three-dimensional surface imaging (3DSI) or computed tomography imaging (CTI) data were reconstructed into a 3D model by Mimics software. PCS was performed by simulating the changes in bone and soft tissue. The stimulating volume change was calculated by Boolean operations. Finally, the virtual model was exported into 3D printer to produce physical templates to guide surgical plan. PCS and actual postoperative results were compared using objective rating scales and by cephalometrical measurements. With the direct guidance of PCS and 3D templates, contouring procedure was performed accurately. Satisfactory facial contouring was achieved with less operative time. As the plastic surgery panel rated, 45.8% of the 3DSI results and 41.7% of the CTI results were identical with the actual outcome, and 0% of them was poor. There were no significant differences in patient satisfaction between the PCS of 3DSI and CTI. Preoperative computer simulation is an accurate method for designing contour adjustment plans, and can be an efficient and reliable predictor of outcomes with customized templates.