Restoration of facial defects can be accomplished either surgically, prosthetically, or by using a combination of both methods. The choice of method depends on many factors like size and location of the defect as well as the age of the patient. Surgical reconstruction is indicated when the defect is small, involves mobile structures like eyelids or lips, or it occupies the are of the cranial vault.
The prosthetic approach is superior to the surgical approach if the defect is larger in size or if the blood supply to the area is compromised for example a nasal septal defect. "Color match" and "patient acceptance", especially in nasal or auricular prostheses, make prosthetic rehabilitation more advantageous to the surgical approach, especially if the defect is large like mentioned before.
It is important to use prosthetic materials with certain properties in order to achieve the best clinical success and patient acceptance. These properties include color stability, ease of fabrication, dimensional stability, and edge strength. Flexibility, low thermal conductivity, biocompatibility, and surface texture are also important. Silicones are the most widely used of materials for facial restorations here in the United States. The type most commonly used, RTV Silicone, has surface texture and hardness within the range of human skin.
Methods for attaching and holding facial prostheses must be as invisible and discrete as possible to make them more aesthetically pleasing. Using tissue undercuts or attaching the prosthesis to the patient's eyeglasses or dentures can help mechanically retain the device. Medical-grade adhesives or tapes are also under study for this purpose (like shown below); the downside to this is that they collect dirt and are unhygienic.
(An artificial nose is attached with medical-grade adhesive.)
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