March 1, 2008 Biomedical engineers developed a process to make it easier to create a custom nose shape for patients. It uses laser surface scanning to create more accurate shapes and a plastic prototype model. This allows doctors to construct an accurately shaped nose using skin and cartilage from other parts of the body.
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Patients who have been disfigured by birth defects, accidents or disease could have the opportunity to lead a new life, with a unique new way to re-build noses and other facial features. Samantha Winpiglar and Pat Petricko had nose cancer, and had all or part of their noses removed.
"When I came out of surgery a couple of times and saw what my face looked like, what my nose looked like, I did a lot of crying," says Petricko.
"People actually didn't recognize me as who I was," adds Winpiglar.
Now, being recognized isn't a problem. Since their dramatic transformations as the result of a unique process that facial, plastic and reconstruction surgeons use to re-build and make new, realistic noses.
"So what we started doing is creating custom noses in the lab with the patients, and doing so in a way that it would provide a perfect fit to the face," says Patrick Byrne, M.D., a facial plastic surgeon at Johns Hopkins Hospital in Baltimore, Md.
A 3-D image of a patient's face is created. Then a laser beam scans a sculpted nose producing a digital model of a new nose. Then a clear prototype of the nose is made that doctors use as a template during surgery, re-constructing a nose using skin and cartilage from other parts of the body.
The procedure means patients get a permanent, custom-fit, real nose. For Pat and Samantha it's made looking into the mirror easier, liking what they see.
"My nose is a little bit different, but for the overall picture I'm still the same," says Petricko.
"As far as who I am what I do … that hasn't changed at all, just maybe a stronger, a stronger person," says Winpiglar.
Doctors also use the process to rebuild other parts of the body, like ears, hands and feet.
THE NOSE SMELLS: The cells in our nose have protein receptors which bind to chemicals in the air. Each kind of receptor can only detect specific chemical compositions, producing the sensation of different smells. The brain receives signals from the cells in the nose, and we perceive that as a smell. These receptor proteins are produced from about 1,000 different genes: almost 3 percent of our total gene count.
RECONSTRUCTING HEARTS, TOO: For some patients undergoing surgery for congestive heart failure, there's a new tool: a plastic device, called a mannequin, which is inserted into the ventricle and inflated to the size of a healthy heart. The patient's heart wall is then molded around the device. When it's perfectly shaped, the device is deflated and removed, giving the patient increased chances of post-operation success.

