First of all I’d like to thank everyone who took the time to reach
out, I had an overwhelming response to this thread. I’m very thankful
to have this resource and even more thankful to have colleagues that
are willing to share their experiences!
Several of you requested I post my responses and so I’ve done so below.
Ashley Seefeld CPO
Berke Prosthetics and Orthotics
-Try calling Scott Sabolich Prosthetics and Research in Oklahoma City.
Theyve done several over the years and are quite good at it
-I do these quite regularly. I have done them a bunch of different
ways but alginate/replicating silicone was most accurate as far as
tiny detail. If this isnt required then I use my tracer white light
scanner. Structure isnt as accurate and will have a larger learning
curve with accuracy. I will slow my carver down and increase detail on
the setting and carve a face. We can 3D print or make it with any
material needed. Not much different than a check socket. As far as
price, OTS versions are cheap. I typically let them go for about
200-350 depending on complexity. Thats also why I cant central fab.
Costs are way too high. I basically cover the costs. Its about the
service and the ability to provide what most people shy away from.
-Clyde Peach of Indiana Brace used to make them.
– I recommend you hand cast. Unless you already have a scanner.
To start cut out a skull cap. And grease up patient with Vaseline.
Lay out cut strips of plaster of Paris. I like cellona because its
Layup however you are comfortable. If you had a manikin you could practice.
Once u pour it buildup the bridge of the nose and smooth. Pull with
vivak or black plastic depending on patient. Line with aliplast.
-It has been ages since I have done one, but I hand casted with
plaster strips. We then pulled it like you would bubble form a check
socket with a clear plastic (I do not recall the type).
-Cooper at Protosthetics: We would be happy to help you with
fabrication of custom facemasks. This is something we have gotten down
pretty well. We can take structure scans and produce a very strong
clear polycarbonate mask for any facial fracture. Let me know if you
would like additional information!
-I have done a few in the past and they are relatively easy to do. I
have used both alginate and plaster bandage casting techniques and
have had best luck with a simple plaster impression. Use vaseline on
the eyes, eyebrows, and hairline with stockinette over hair. Mold
intimately around eyes and nose (have patient breath through mouth).
Take mold off extend and pour with plaster. Mods are also simple.
Modify on cheeks and forehead to preload. Generally only need small
build up over nose. Pull with a thin vivac or durplex. Work out
trimlines on patient. Hardest part is getting everything symmetrical
and strapping. Elastic velcro with self adhesive hook has worked for
me. It is not very complicated and works well. In regards to billing
we have billed misc code (99s) and in regards to cost it was $300-$400
I believe. Please feel free to reach out with any further questions.
– Its been a while since Ive seen one (I had a boss that did them a
lot about 7-8 years ago) but what jumps out in my memory is that they
were often denied as not medically necessary as they are for sports
and we had issues getting families to pay. By the time the denials
came, a lot of kids didnt need them anymore after the season finished
in the next month or two and we had so many issues with families just
not paying anymore to where we asked for 50% to fab, 50% at delivery
and reimbursed if insurance covered them. Sounds harsh but just be
careful if you try for insurance and operate expecting a denial.
-If you want to talk, I made Ayo Dosunmu mask back in March/April, look it up.
OMNI Prosthetics and Orthotics, Inc
-It s been a long time , but the last one I did we used alginate and
then strips of plaster to reinforce. Make sure to Vaseline eyebrows,
etc for release. I recommend practicing on a willing staff member
first. Good luck
-Ive done several for college basketball teams
Plaster molds and used Vivak/PSEG 3/16 thickness blister mold
-Jeremy Murray does this. Custom face masks.com. He has been doing
these for years.
– We have done a couple of these over the years, both making them
ourselves from our digital scans as well as sending our scans to a
company called Murray Masks out of Michigan (metro Detroit area if I
recall correctly). It’s been a couple of years, so I don’t have their
contact info but might be a good place to start – they did a great job
– I do 5-10 custom fracture masks a year for a local college and a few
high school student athletes. I generally scan with Omega scanner and
have Orthomerica fab the mask. The one thing that I do know is that
the state high school and NCAA have different rules on what they can
be made out of and the color that they can be. Almost every athlete
that comes in requests a carbon fiber mask, but my state does not
allow for anything other then clear. Hope this helps. We bill these as
a L3999. Hope this helps. The fitting process is pretty simple. First
I add proper padding to the cheek line and forehead to get proper
distance away from the fractured area. Once the fit is determined to
be good, I determine the proper eye cutout size and open them up. I
also always have the athlete bring a ball with them and we go outside
and pass the ball around to make sure that there isnt any blind
-I only did one, for a friends kid who played basketball and had
broken his nose but needed to be able to play sooner than was
advisable. I hand casted his face with strips of plaster and straws
in his nose for breathing. Used a ton of Vaseline as a separator and
it came out pretty darn accurate. It was a bit of a nervous day
because I was worried hed come out of the cast with no eyebrows! But
it all worked out fine. Good luck
-I used to have the patient sit in a chair with their head propped
back (like when you get your hair washed at the hair salon). I would
apply Vasoline on their face and any hair near their face and then
drape plaster bandage over their face capturing a good impression of
their nose and cheeks.
Now, we use the Vorum Spectra scanner; a much faster and cleaner
process. I use 1/8″ Surlyn for plastic and configure the straps during
the fitting. It seems like I am always changing the strap
configuration depending on the kids head shape and their sport. Hope
-there are off the shelf models that work very well
-It has been quite some time since I have personally fabricated a face
shield, but I have done some in the past. When doing so I used plaster
to capture the model. I used Vaseline to prevent removing the patients
eyebrows and as a mold release. I would build up at the apex of the
nose, cheek bones and super occipital ridges to redirect forces more
evenly across the face. We used 1/4 inch vivak, and ground out three
slots for straps.
I would think that the structure scanner would be the best approach,
but I would investigate potential injuries using a laser near eyes. I
don’t think it would be a problem, and simply keeping your eyes closed
would probably address the issue sufficiently.
-I worked with burn masks before, and I believe the process is very
similar. We used a StarScanner (typically used for baby CROs). You
have the patient lay forward into the star scanner with their head
down into the machine and shoulders at the side. A scan is taken of
their face while they stay still. We sent our scan to Orthomerica.
They have an option to make custom masks. Since ours was for a burn, I
believe our plastic was lined with silicone. However, you can order
with or without silicone and choose the different types of plastic
you’d like (firm or flexible).
I think this same process could be used for a Structure scanner and
you can find the order form from Orthomerica on their website for
Ashley Seefeld, CPO
Berke Prosthetics and Orthotics
2001 Winward Way, Suite 100
San Mateo, CA 94404