3D Printed Implants Help Reconstruct Man’s Face in Pioneering Surgery

When Carlos Askew was born to a drug-addicted mother, he was immediately removed from her care and placed in the custody of the state. In addition to the disadvantageous start he got as a result of his situation, he also was born partially deaf and with facial deformities caused by hemi-facial microsomia. This condition, HMF for short, is caused when there is a vascular malfunction while the fetus is in utero and results in slowed development in the affected area. Growing up with a difference can lead to feelings of shame and worthlessness, particularly in a child who lacks a supportive environment, and Askew was unfortunate enough to have lacked a supportive family structure and instead was subjected to years of mental and physical abuse as he was shunted from home to home for the first seven years of his life.

When he arrived with the family that was to finally fold him into its arms as one of his own, he was suffering from severe emotional damage in addition to the physical problems that his condition presented. Luckily, the Askews stood beside him through thick and thin, despite what sometimes felt like impossibly difficult circumstances, as his foster mother explained:

“[He was] very damaged. I don’t think he knew how damaged he was until he got older. It took us a long, long time to get through a lot of this. It was really hard, the abuse and the damage we would go through. Curtains ripped off the rails, TV smashed to bits, bench tops, knife cuts through them, all because he’d get angry or really upset with me.”

Dr. Goodisson and Askew posing before the life-changing surgery.

But Askew said despite all of this, his parents have been there for him and forgiven him for the difficulties and distress. In the meantime, however, he desperately looked for the acceptance of his peers, even when it meant joining in the teasing and taunting by adopting their hurtful names, such as ‘shovel face’, for himself. Now, a young man, he faces all the uncertainties and insecurities of anyone that age, built on top of his own perception of himself as damaged and deformed. All of this led to thoughts of suicide, as whatever wells of inner strength began to run dry after years of drawing upon them for survival.

But recently, Askew has been presented with a new opportunity to have a new face. Dr. Derek Goodisson, a maxillofacial surgeon based in Hawk’s Bay, New Zealand, believed he could help reshape Askew’s face using TruMatch CMF to create 3D printed patient-specific titanium implants. The surgery will break the bones in various parts of Askew’s face and then insert the titanium implants designed to mirror the normally developed portion of his face. The implants alone will cost $60k NZD (just over $40k USD), but the Dr. Goodisson says it’s worth every penny:

Dr. Goodisson showing the ProPlan software and models he used to plan the surgery.

“I would challenge anyone to deprive a young man of his future. All he really wants to do is look as normal as he possibly can. The surgery is quite a motive, we do change people’s lives quite significantly.”

This surgery took approximately 9 hours and was the first of its kind ever undertaken in New Zealand. And the recovery process would be a long and sometimes brutal journey with Askew sometimes feeling as if he had taken steps backwards and wishing that he could hide away, putting on masks and attempting to keep his face from the public eye. However, he finally confronted his own fears and decided to put the mask aside. In a big reveal, he met with the reporter who had been covering his story and took off the mask. The result is indeed stunning; while there are differences between the left and right side of his face, they are so much more similar that they wouldn’t cause a second look, other than to notice a handsome, well dressed young man.

One of the facial implants used during surgery.

While there are still some steps to take, such as removing the bands, the result of the surgery can be counted as a success and the affect it is sure to have on Askew will, no doubt, be life changing not only for him, but for the advances that such operations bring to the practice of the creation of facial implants. These tailor made implants were made possible with ProPlan CMF planning software and additional assistance was provided through the creation of 3D printed surgical guides created by Materialise. In a statement released by Materialise, the company expresses the meaning behind the way in which their work is undertaken:

“Carlos Askew’s story showcases the true potential of 3D Planning and Printing. The ProPlan CMF software enabled the creation of detailed preoperative plans, allowed for the design of patient-specific implants, reduced the number of intraoperative decisions as well as the turnaround time, and facilitated a more predictable outcome. The customized fit helped restore the symmetry of Carlos’ face. But, more than anything, this pioneering surgery improved Carlos’ quality of life significantly.”

Askew has had enough to overcome in his life, enough struggles and difficulties, that it is a beautiful thing to see how the support of others, whether his parents or his medical team, can help to ease his burden and help smooth his way.

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