Reconstruction of postoperative deformation of the upper third of the face using individual polytetrafluoroethylene implant

The authors describe a patient with right-sided postoperative deformity and paralysis of facial musculature of the upper third of the face. The patient complained of soft tissue asymmetry of the upper third of the face, paralysis and ptosis of the right eyebrow and upper eyelid. The purpose of surgical treatment was simultaneous correction of soft tissue asymmetry, right-sided gravitational abnormalities of the upper third of the face and symmetrization of paralyzed upper third of the face. The most common treatment methods for deformity are autol-ogous bone grafting with parietal and mandibular bone flaps, repair with standardized implants, custom biocompatible implants, lipofilling and microsurgical grafting of vascularized free tissue complexes. We preferred a customized polytetrafluoroethylene (PTFE) implant with simultaneous intersection of temporal branch of the left facial nerve and static correction of the upper third of the face for abnormal commu-nication of cranial cavity with temporal fossa through transtemporal defect after previous surgery. Intervention was performed via bicoronal access with preservation of dura mater. Implant was positioned and fixed by microscrews in the right temporal region. On the left, we inter-sected frontal and temporal branches of facial nerve to symmetrize movements of the right side, as well as performed static correction of soft tissues of the upper third of the face. Postoperative aesthetic result completely satisfied the patient. This method requires more thorough pre-operative preparation at the stage of 3D modeling of implant. However, this is compensated by less surgery time, shorter postoperative reha-bilitation and no need for correction of implant and development of cavities in the wound due to ingrowth of tissues into implant. These fac-tors reduce the risk of implant displacement. © 2023, Media Sphera Publishing Group. All rights reserved.