A Novel Design Strategy for Customized Polyetheretherketone Implants in Paranasal Augmentation Through Surgeon-Engineer Collaboration.

backgroundParanasal concavity, particularly prevalent in East Asian females, contributes to a prematurely aged facial profile. The paranasal augmentation with customized polyetheretherketone (PEEK) implants offers an effective solution for this aesthetic concern. However, conventional design strategies often encounter challenges in bridging the knowledge gap between surgical requirements and engineering implementation, which may result in unsatisfactory aesthetic outcomes. The optimized interdisciplinary approach is required to integrate clinical and engineering expertise. Therefore, the present study aims to introduce a novel design strategy for customized PEEK implants in paranasal augmentation and to investigate clinical outcomes.

methodsThe present study enrolled 36 consecutive female patients with bilateral paranasal concavity. A surgeon-engineer collaboration workflow was established. The placement position, size, thickness, screw channel, and surface morphology of the implant were the key factors for implant design. Perioperative medical data were meticulously collected and analyzed. The outcomes were evaluated by objective quantitative measurements (maximum concavity depth of paranasal region, nasolabial angle, alar base width, nasorostral angle, philtrum length, and nasal columella length), and subjective questionnaire focused on satisfaction and design experience.

resultsThe mean operative duration was 55.28 ± 10.89 minutes with minimal intraoperative blood loss. The most common complication was transient perioral numbness. The wound nonunion and infection were not observed in all patients at final follow-up. Quantitative analysis demonstrated significant improvements in paranasal region: maximum concavity depth decreased from 5.45 ± 0.68 to 1.64 ± 0.53 mm (right side, p<0.001) and from 5.62 ± 0.70 to 1.53 ± 0.64 mm (left side, p<0.001). The nasolabial angle demonstrated a statistically significant increase from 90.49 ± 4.53° preoperatively to 95.33 ± 4.75° at final follow-up (p < 0.001). The subjective outcomes of patients revealed 83.33% satisfaction with aesthetic improvement and 72.22% enhanced self-confidence. A significant proportion of patients expressed high satisfaction with the design process for customized PEEK implants.

conclusionsThe novel design strategy through surgeon-engineer collaboration for customized PEEK implants demonstrated remarkable efficacy in paranasal concavity correction, achieving satisfactory aesthetic enhancement. The interdisciplinary approach highlights the critical integration of clinical expertise with engineering precision. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .