Using Bio Scaffolds To Augment Cheeks/Orbital Rim

[overbiter]

People on this forum have pointed out before that current techniques for augmenting the malar/orbital region are limited. Using an osteotomy and bone grafting approach can only achieve small gains, plus multiple surgeries would be needed for a three dimensional augmentation. Following a synthetic implant approach, has all the downsides of introducing a foreign material into the body and everything that goes along with that. Neither technique is likely to create the perfect aesthetic ideal of strong natural cheekbones, but there may be another option.

I've been wondering for a while whether an approach using bio scaffolds, impregnated with stem cells, could be the answer to this tricky problem. Basically an implantable scaffold would be created by the surgeon using a 3D printer. Then the surgeon would then fit the custom implant to the patient, just as in a standard implant operation. As the new bone formed the scaffold would disintegrate, leaving only new formed bone in the shape of the original scaffold.

This technique has been used many times by surgeons around the world, for treating bone injuries/deficiencies as well as for creating new soft tissue to be used in ops. I've found out through Google search that it was used on a Treacher Collins syndrome patient, for cosmetic improvement of the cheek bones. That was at least six years ago I believe, because the article was dated 2009.

http://www.scientificamerican.com/article/stem-cells-bone-growth/

I also found some information here.

http://www.bio-scaffold.com/web/professionals/cosmetology/

Does anyone know where else information on this can be found? It seems there is not a lot on info out there, although there must be surgeons who can perform these types of procedure.

[overbiter]

The largest concern would be the donor bone and fitting it into place. The 3D printer sounds like a good idea instead of having a doc carve this stuff out...  anyhow, it's still an issue since bone has a way of warping over time (unpredictable) and revision for bone is extremely hard/impossible and disfiguring. 

I still think moving your own bone is the better option.




And donor cadaver bone? Planned Parenthood to the rescue...

I was thinking more of synthetic scaffolds made from plastic. I know that surgeons are using these now. Maybe that kid did get donated bone, but there is no reason why synthetic scaffolds shouldn't be used. I know of one trial using synthetic materials to grow new hip joints. So if synthetic scaffolds can be used for hips why not cheekbones? Isn't growing a few millimetres extra cheekbone easier than growing a new hip joint. Synthetic scaffolds are the future for this type of surgery. I truly believe that.

[Lazlo]

I think these are very very exciting ideas. If such applications have already been used to treat facial deformities, then the technology is there.

Listen, if they can clone a f**king hamburger from a few cell's of cow meat, then they can definitely human tissue. The problem with the hamburger was that it took 100 000 dollars to clone the fake hamburger.

Can they do the same for human tissue at this point? Definitely. I love the bioscaffold idea. Let's take it another step. Get 3-D scans of the worlds most beautiful people. Have a bio-scaffold based on what movements you'd need to morph your own frame into said beautiful person's. You'd essentially move a lot closer to looking like that person.

All of that said, I think skin quality and hair quality go a long, long way.

[overbiter]

I think these are very very exciting ideas. If such applications have already been used to treat facial deformities, then the technology is there.

Listen, if they can clone a f**king hamburger from a few cell's of cow meat, then they can definitely human tissue. The problem with the hamburger was that it took 100 000 dollars to clone the fake hamburger.

Can they do the same for human tissue at this point? Definitely. I love the bioscaffold idea. Let's take it another step. Get 3-D scans of the worlds most beautiful people. Have a bio-scaffold based on what movements you'd need to morph your own frame into said beautiful person's. You'd essentially move a lot closer to looking like that person.

All of that said, I think skin quality and hair quality go a long, long way.

LOL, celebrities are going to be so pissed off if there are thousands of clones  of them walking around. They'll be like 'hey, now everyone looks like me ..... f**k!". That would be hilarious.

[overbiter]

This article says that a team is working on making 3D printing of artificial bone commercially available by early 2016.

http://www.engineering.com/3DPrinting/3DPrintingArticles/ArticleID/8134/Using-3D-Bioprinting-for-Artificial-Bones.aspx

[JayJaw]

This sounds like a pretty awesome future alternative.

[Lazlo]

yeah 2100 will be a great year to be alive.

[overbiter]

yeah 2100 will be a great year to be alive.

We won't have to wait that long.Read the article.

http://www.engineering.com/3DPrinting/3DPrintingArticles/ArticleID/8134/Using-3D-Bioprinting-for-Artificial-Bones.aspx



http://www.creationengineering.co.uk/biomedical-technology.html

[Lazlo]

once you get your face and jaws the way you want them, please, go into comedy you have a nack.

It's funny you say that. Several of my friends have suggested that I go to open mike's for stand-up, as has GJ. Yeah after surgery, and I'm healed I will give it a shot.

[molestrip]

You're right scaffolds exist today and they're used on the face. I haven't asked my surgeon but some use them as structural grafts I believe. You are mistaken, however, there are downsides to the plastic. It creates a large inflammatory response as it degrades and it doesn't always fully degrade. Foreign body reactions are still possible. Infection can be a problem and a big one if it occurs inside the bone. You'll still need to fix the graft until it heals and it may shift during that time. Resorption is possible afterwards as well. The muscles and connective tissue surrounding still need to be disturbed, that's a problem with all surgeries in this area but it tends to age the area. There's no reason to think it'd look better in a decade or two once the fat pads start thinning, however it's a good option once that's occurred since you can see the implant more clearly. I've read that 3d printing of implants already exists it's just expensive and results aren't better than a skilled surgeon can do. I think long term 3d printing has a lot of potential but the technology is still maturing. Probably the biggest drawback to this approach is why would you want to wait for the bone to grow into the scaffold? You can implant real bone, either cadaver or your own like epibone does. Then all you need to do is wait for the bone gap to heal.

Resorbable plates and screws would be very nice here but surgeons don't like using them because they're not very strong (plus the inflammation/foreign body issues as above). I remember reading Tufts had a silk alternative that was supposed to be as strong as titanium and resorbable, who knows when it will hit market. Why is there no resorbable cement? Wouldn't it be nice to avoid all the problems of plates and screws? Easier to say it should exist than to actually make it of course.

[Lazlo]

We won't have to wait that long.Read the article.

http://www.engineering.com/3DPrinting/3DPrintingArticles/ArticleID/8134/Using-3D-Bioprinting-for-Artificial-Bones.aspx



http://www.creationengineering.co.uk/biomedical-technology.html

so i'm not trying to be combative but i think we're missing something crucial here. how do you induce he "osteocyte cells" to actually grow into the bioscaffold? I remember reading about all these organ 3-D prints they've done, they're just a shell coated with the cells from that organ, they're not the actual organ, nor do they know how to make the cells reproduce and grow into the shell. That's the real problem. Like for bioscaffold's for teeth. they don't know how to make the cell's reproduce into the bioscaffold. I suspect all of this is just good marketing. That is, yeah they can print the shell, or a resorbable shell etc. but they're waiting for science to make massive breakthroughs into how to get a large enough supply of cells to create the different organic structures in the first place.

[molestrip]

Growth factors I thought. BMPs are just one class. The more interesting concern to me is, how do you keep the thing alive while it's growing? Don't you need a continuous blood supply, functioning immune system, etc?

[overbiter]

Growth factors I thought. BMPs are just one class. The more interesting concern to me is, how do you keep the thing alive while it's growing? Don't you need a continuous blood supply, functioning immune system, etc?

I don't think the printed bones need a blood supply straight away. They're just empty scaffolds seeded with stem cells and growth factors. The cells grow and multiply after they are implanted.

The point Lazlo made about the artificial hamburger has merit, but remember this technology isn't about creating fully formed organs. These are only scaffolds, the cells grow once the scaffold is implanted. Trying to grow muscles, organs and bone in a lab is hard. That's why people aren't growing hamburgers in factories. With this technology though it is the human body that does the work, not a scientist in a laboratory.

[Lazlo]

we still don't have the technology to make the bone cells just grow within a bioscaffold. And even if we did, imagine how long it would take, way longer than the bioscaffold would last. How long do adult teeth take to grow in? Years.

[overbiter]

we still don't have the technology to make the bone cells just grow within a bioscaffold. And even if we did, imagine how long it would take, way longer than the bioscaffold would last. How long do adult teeth take to grow in? Years.

We don't need technology to make the cells grow, the body/cells do that on their own. It's called healing. This stuff isn't Sci-Fi, what I'm talking about already exists. People and animals have had this tissues implanted already.