A cosmetic prosthesis is a life-like synthetic product, used by disfigured people to restore their normal symmetry of appearance.
Its purpose is social rehabilitation enabling the disfigured person to avoid receiving morbid curiosity and pity from others. It would benefit patients who have lost an ear, orbit, nose, maxilla, breast, finger, hand or toes.
Speaking to Gulf News, Daril Atkins, Senior Prosthetist at the Cosmetic Prosthetics Section at Rashid Hospital in Dubai said the section was established in 1985 at Rashid Hospital. It was the first in the GCC and is the only one in the UAE.
"Our section covers a wide range of problems, unlike some of the other prosthetics centres in the GCC," Atkins noted.
He said they receive patients from all over the region, as well as the country.
"Plastic surgery, better called reconstructive surgery is always the first option. However, if the person decides to either rule out or postpone further surgery, due to contraindications, he may prescribe a cosmetic prosthesis for temporary or permanent use," he said.
"About 70 per cent of the patients we receive are eye patients who want an artificial eye."
Atkins said they are making parts of the body which look like original or real parts.
"These parts do not do any work in dynamic function, but it is a way of camouflage. It is for people who have certain defects on the body, face, hands and toes," Atkins said.
He added that all the artificial parts are custom built, first with a three dimensional cast measurement.
Then a model of the prosthesis is taken and designed in every detail, until finally a cast is produced and coloured to match the patients skin.
Silicon polymer
At Rashid Hospital, the material used is a medical silicon polymer.
"We make these parts here at Rashid Hospital, but we get the raw materials from abroad," he said.
Anyone could suffer the loss or absence of an external body part, due to an accident, disease or a birth defect. Such individuals are eventually referred to a plastic surgeon.
"At times, the reconstructive surgeon may recommend restorative prosthesis rather than surgery," Atkins said. Individuals with birth defects who apply for restorative prosthesis usually have an absent or malformed eye, or problems with their fingers or toes.
According to him, individuals who have been victims of an accident have often lost an ear, an eye, their nose, part of the face, or part of the hand or foot.
"Thus, in the area of cosmetic external restorative prosthesis we make these items," he said. The section makes flexible parts, which can move with the part of the body to which it is attached.
Patients usually do not go to the prosthetics section directly, but are instead referred from other sources, such as plastic surgeons, ear nose and throat specialists, opthalmologists and oncologists.
Procedures
Atkins said the pre-operative stage is the correct time to plan a cosmetic prosthesis because part of the surgical procedure may facilitate better prosthesis results, retention or camouflage.
"If the surgeon prescribes a cosmetic ear prosthesis, it will be necessary to improve the site. The excess, or malformed, or displaced cartilage and tissue will have to be trimmed and repositioned. The low hairline will have to be raised.
"When the patient first come to us, we diagnose the case, and then make a plan on what should be done and how.
"In this process, we try to hide the problem from the society and give the patients self confidence to go out into society and face people."
The most important part in the whole process is getting the correct measurements.
Some patients simply want to clean or replace old items.
"Our main work is on the eyes, the fingers and then the hands. And we try to bring the item as close as 100 per cent to the real part.
"We import the raw materials from countries like the US and Germany, and the cost of our work is very favourable compared to the price of the same items abroad."
Main problem
Atkins added that the main problem after finishing the prosthesis is fixing it firmly on the body.
"The methods used to stick these parts changes every now and then, which can create difficulties."
After any surgical procedures, prosthetics experts must take account of swelling or scarring while fitting an artificial part. Making the parts can be time consuming in itself, but there is often a long wait before patients can even be measured for a part.
"On average, we get 100 patients a year, but each one requires a completely individual approach. The amount of time taken for completing a part varies from one week to one month."
PATIENT CARE
Starting anew
70 per cent of all the prosthetics are for patients with eye problems. 25 to 30 per cent are children. 40 to 50 per cent are males aged between 20 and 35 years.
Time frame
Two weeks for the eye. Two weeks for fingers. Two weeks for face parts. Three weeks for a hand. Two weeks for the toe.
Limitations
Reconstruction of the ear may be ruled out due to excessive scar tissue, for example after a burn. Radical surgical excision of malignant tumours, where the post-operative need is radiation therapy and repeated clinical observation for recurrences. Reluctance of the patient to have a series of recontructive procedures.
Gulf News
