Subperiosteal Implants: Rebuilding the Facial Skeleton Without Grafts

A subperiosteal implant is a patient-specific device designed to rest directly on the cortical surface of the facial skeleton, reproducing or augmenting the bone's natural contour. Because its entire bearing surface is engineered from the patient's CT, it conforms like a bone graft — without harvesting one.

Indications

• Contour defects after trauma or tumour resection
• Congenital deficiency: hemifacial microsomia
• Malar, chin and mandibular angle augmentation
• Orbital rim reconstruction where volume is the goal

Design principles

Three rules dominate: total surface conformity (no rocking points), feathered margins (edges taper under a millimetre so they are neither visible nor palpable), and deliberate retention (undercuts or micro-screws on thick cortical zones). In the mandible, designs respect the inferior alveolar canal and mental foramen.

Advantages over grafts

No donor site, no resorption, no remodelling over time — the contour designed at the computer is the contour at five years. For combined cases, subperiosteal implants can be designed alongside dental or orthognathic planning. Submit a standard facial CT through the case form; design review and a firm quotation are returned within one working day of validation.