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CENTURY MAKERS AND MATERIALITIES
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CENTURY MAKERS AND MATERIALITIES
Proceedings of the 2nd Biennial
Research Through Design Conference | RTD 2015
Guy, B., Stevens, R., Challies, Z., Gillingham, W. 2015. Synthetic Anatomies, Co-designing
desirable 3D printed facial prosthetics. In: Proceedings of the 2nd Biennial Research Through
Design Conference, 25-27 March 2015, Cambridge, UK, Article 32.
DOI: 10.6084/m9.figshare.1327991.
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Synthetic Anatomies, Co-designing
desirable 3D printed facial
prosthetics
Bernard Guy1, Ross Stevens1, Zach
Challies1 and Wayne Gillingham2
1 School of Design, Victoria University of Wellington
Wellington, New Zealand
{Bernard.guy; Ross.stevens}@vuw.ac.nz
zschallies@gmail.com
2 Welloral Ltd
Wellington, New Zealand
wayne@welloral.co.nz
Abstract: Desirable prosthesis is an early stage investigation formulated to
explore the creative potential of 3D scanning and 3D printing in designing
alternative facial prosthesis. The loss or disfigurement of a person’s facial
feature such as a nose or an ear is typically supplanted with a hand crafted
silicon prosthesis designed to replicate the person’s face pre surgery. Our
research sets out to counter the traditional medically orientated art of
camouflaged reconstructive silicon prosthesis and explore the design of
3D printed distinct and desirable prosthesis.
Together, the participant, designers and a maxillofacial surgeon explore
ways to think about how new prosthesis might fit, feel, empower and
be made. In conjunction to this we explore 3D laser scanning and the
Objet Connex multi-material 3D printer to build prosthesis which allow
greater facial expression and personalisation for diverse social activities.
Designing desirable facial prosthesis proposes a shift from localised hand
craft to a global digital process where prosthetic clients from around the
world can interact, design and print personal prosthesis on ‘state of the
art’ machines at a cost well below those hand crafted. Potentially enabling
individual expression in performance, fit and aesthetics rather than the
predominately ill-fitting attempts at camouflage currently prevalent.
Keywords: Prosthesis; facial; 3D printing; anatomy; digital craft.
Guy, Stevens, Challies and Gillingham | Synthetic Anatomies, Co-designing desirable 3D printed facial prosthetics
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Rationale/Aim
Facial prosthetics are relatively rare yet they have a critical role in allowing
patients to confidently interact with the world which can lead to a life
less full (Chang, 2005). Eggbeer’s thesis ‘computer aided design and
fabrication of facial prostheses’ (2008) and the applied research centres
Cartis and PDR are examples of the capability of emerging and advanced
digital technologies in 3D scanning and printing to alleviate the challenges
of economies of scale and quality of individually manufactured facial
prosthesis (Eggbeer, 2012). This research aims to oer consistency and
support for the dramatic increase in facial prosthesis at the professional
and demanding front end of healthcare. As designers we intersect the
world of engineering and art, and as such oer a specifically aesthetic
understanding and sensitivity to the possibilities of these new technologies.
This research is a practice based response to current methods of prosthesis
creation that conspire to hide both tissue damage and arguably the person.
The project was inspired by our research into the variable densities of
the Objet Connex multi-property 3D printer, where materials are laid
down layer by layer in a range of material qualities from hard (bone) to
soft (flesh) that mimic the pre-existing physical anatomy. A tangible
demonstration of design potential for 3D printing to mimic human
anatomy was explored in an earlier design experiment, where a human
ear was printed from MRI scans in multi-property materials (Fig.1). This Figure 1. 3D printed ear in multi-property material.
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Guy, Stevens, Challies and Gillingham
Expanding this question through practice demonstrates an argument for
developing more individual, empathetic and desirable prosthetics. The aim
is to exhibit how 3D scanning and 3D printing can allow the production
of digitally tailored prosthetics that fit more exactly to the individual both
physically and emotionally. This approach brings a human dimension to
digital technologies. While technology inspires and shapes us, it is also the
role of design to shape technology for the benefit of humanity. It is at this
example of simulated anatomy and timeliness with 3D printing and digital
customisation was seen as an alternative manufacturing method, with
conversations with medical practitioners producing an explorative debate
around facial prosthesis – what could the patient have, rather than what
would the patient want?
Figure 2. 3D scanning to gather a
digital map of the face.
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participant who had lost his nose due to skin cancer, and a group of
industrial designers. The aim of designing an alternative facial prosthesis
that defies the aesthetic goals of facial normality is sensitive. To envisage
alternatives meant that this project was speculative, requiring a very
personal context and confidence in our group practice.
Opportunities of non-look-alike prostheses to enhance satisfaction of
the wearer and emotional value of the product have been previously
explored. Scott Summit of Bespoke Innovations creates prosthetic
limbs (mainly legs) that take into account the wearers’ personality and
interests, designing with the ‘face, name and story’ behind the person,
not around society’s expectations of what a prosthesis should look like
(Summit, 2010). He also talks about shape, materiality and context being
an important way of adding value to transform a prosthetic, usually a
utilitarian device, into an extension of the wearer’s personality.
A contextual precedent is corrective spectacles, a condition of necessity
and, in contemporary society, style and identity. We use the example of
spectacles as an informal hypothesis, that to create desirable prosthesis
a precedent for acceptation is required. Early spectacles were wire edged
and crafted to reduce apparent disability to a minimum, and later became
fashion items styled according to function, activity, facial shape and
aspiration. The acceptance of desirable facial prosthesis may come through
point - where the social, behavioural and cultural insights meet technology
- that truly innovative, unexpected and meaningful design opportunities
emerge.
3D scanning and generative software now make highly customisable and
financially viable prosthetics a reality (Fantini 2012). The scanner maps
facial morphology as an anatomical landscape from which we can both
generatively model underlying support structures to fit location abutments
and create novel facial contours (Fig. 2). These digital models can then be
built as 3D printed multi-property structures with variable densities and
rigidities. Vibrant colour multi-property printing using the Objet Connex
system has been explored by Neri Oxman. Oxman (2011) has investigated
the complexity of material mixing in a variety of visual and performance
based artefacts. However, it has been applied predominantly in industrial
design as a method of prototyping for traditional manufacturing
technologies rather than a designed outcome in itself. This method of
making has received little investigation for its potential to mimic anatomical
tissue in both compliance and colour.
In this paper we describe the practice of creating an unconventional
prosthetic nose. The work began with design experiments founded on
conversations, demonstrations, and photography with three parties,
a Maxillofacial Surgeon and Maxillofacial Prosthetic/Technologist, a
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Guy, Stevens, Challies and Gillingham
camouflage the deformity greatly reduces resulting in the prosthetic nose
appearing increasingly foreign to the face. Each new prosthesis requires
time consuming face to face consultation, making, fitting, and painting.
Currently facial prosthesis are created by hand using an impression of the
face and artistic interpretation and skill to craft the outward aesthetic.
The cavity between is cast in silicon with tonal pigments matching the
patient, which is then attached to the face with either an adhesive, clips
or surgically fitted magnetic abutments (Thomas 2006) (Fig. 2). The
procedure has changed little since the tin mask innovations during WW1
(Bierno, 2011), where hand painted copper plate skins were attached to
spectacles.
The Wellcome Trust with Fripp Design and Research (2012) have digitally
harnessed the art and craft of facial prosthesis, producing anatomically
correct, 3D printed full colour silicon prosthesis prototypes (Xiao 2014).
However, in moving to a digital process that reduces the personal
interaction between the experienced prosthetic technician and the patient
there is a real risk of creating a technically ecient yet humanly insensitive
process.
design where function and technical benefit is signalled and aesthetics
preferences are hinted, later to become tailored to compliment both
activity and occasion.
The nose is an anatomical mass of bone, cartilage and tissue that assists
respiration, humidity and contains a host of sensory functions, and
yet its form, contour and proportion is a highly visible characteristic.
Rhinoplasty, the surgical reformation of nose shape for aesthetic beauty is
one of the foremost and popular cosmetic procedures (AAFPRS 2014).
These operations attend to perceptions of beauty, correctness, and self-
consciousness (Gilman, 1999). Opposed to purchasing beauty, in New
Zealand facial prosthesis is often the result of skin cancer. Skin cancers
typically manifest on the face and nose, and in New Zealand and Australia
are the fourth most common cancer and the sixth most common cause
of death from cancer (O’Dea 2009). The occurrence of rhinectomy,
the removal of the nose is uncommon; however, in advanced cases of
melanoma it is often the only method of rehabilitation and with new and
advanced methods of diagnosis the call for the procedure is increasing.
However, rhinectomy is classed as non-debilitating and receive little
financial support. The cost is substantial and the silicon prosthesis has a
life of 6 to 12 months as the colours fade, the face changes colour with
seasons and age, and the material degrades from handing and time. During
this degradation process the capacity of the prosthetics to eectively
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evidence-based research, and thus require an understanding of the
designers’ goals by the participant, and the surgeon’s comprehension of
the design’s intentions. Moreover, we argued that design is about the
person and the artefact, with both being paramount in the contextualising
of any design achievement. The nature of this project, and how desirable
prosthetics are explored, evidenced, communicated and experienced, is
inexplicably tethered to its context, the face. Our practice is thus a design
process to draw out the relationship between a person and an individualised
method of desirable atonement.
Evidence in our process revealed design opportunities where digitisation
can promote individualism and endeavour to integrate product to person.
Such an alternative desirable prosthesis may also place the ownership of
craft with the person rather than the medical community.
Experiences and Explorations
As practice based research within a university, ethical approval was sought
and gained, and in doing so issues of the participant’s open and visual
disclosure in publication were raised. As our practice crosses disciplines,
exploration and publication would be very dierent from medicines’
Figure 3a. Exploring attributes in products and searching for design cues.
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Guy, Stevens, Challies and Gillingham
qualities, colour, and brands, then of the activities soccer, fishing and
cooking. We then discussed the loss of a defining facial feature and the
activities that could no longer be pursued. We also spent a day observing
the crafting, casting, fettling, fitting and painting of a prosthesis on our
participant to understand the limitations of current silicon prosthesis,
which further developed our confidence in the project (Fig. 4).
To further our comprehension we took a series of portrait photographs.
Portraits have the ability to share and subjectively understand character.
The activity and images captured a key design insight - our participant
smiled without his prosthesis (Fig. 5). On analysis we understood that the
wide smile deflected the face to such an extent as to risk the dislodgement
Our participant was recruited through the maxillofacial surgeon and
showed interest in participating in the project after experiencing a variety
of crafting and fitting procedures that varied widely in satisfaction. This
intimate awareness of prosthesis procurement, fitting and wearing is vital
to the design process.
To gain an initial anity and gather aesthetic thoughts we spent some
time with our participant. Together we browsed shops of interest where
designed and styled consumer products were handled and discussed,
including a sports shoe department, a fishing shop, and a sunglasses store
(Fig. 3). This experience provided some prompts towards our particular
participant’s aesthetic preference for activity, performance and function.
We photographed these experiences and conversed about material
Figure 3b. Exploring attributes in products and
searching for design cues.
Figure 4. Observing the art of the maxillofacial prosthetist.
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Comments from particapant: ‘Initially after having the nose removed I was advised that I’d be up for a total reconstruction but would have to wait for a year to make sure that all the tumour had been
removed. So the best I had was a plaster covering the hole! Then I was advised that the best way forward would be to get a prosthetic nose. So I went to a technician and it was hopeless. So it was
decided that he would try and get me to see someone who could do a better job. This took quite a long time, eventually they managed to work it that I would see the technician privately. All good until
I had to go up to get some more noses made. At this stage the noses were applied using a special glue (better than a plaster) and only really lasted 4-6 months. What really annoyed me was that there
was nothing in place for people like me to say what the costs are (plenty), what is involved and what to expect.’
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Guy, Stevens, Challies and Gillingham
and professional goal. Moreover, in referring to our participant’s comment
quoted in figure 5, the time consuming search for satisfaction and
knowledge places anxiety on the patient directly after the surgery when
they least need it as they reintegrate into their normal lives.
Process and Procedures
From our experiences, prosthesis fixation, revelation, junctions and form
were identified as design prompts for crafting new anatomy.
To counter the concerns around suddenly losing the nose we explored
various alternative methods of connection to the face that were
sympathetic with the surgeon’s recommendations. The silicon nose
of the nose and for that reason the participant had trained themselves
to not smile. This sad realisation illustrates the critical importance of the
facial prosthetic role in sustaining the emotional wellbeing of the person.
These images also revealed the highly confrontational appearance of a
face without a nose that created a very real and valid fear of exposure
by the wearer. Just how easy prosthetic dislodgment could occur was
demonstrated with a sideways stroke of the finger. This shows that the
empathic understanding of proximity to others is very dierent with the
fear of losing your nose from another’s touch.
Our exploration revealed that in the hands of highly skilled maxillofacial
technicians, artistry and patient empathy continue to remain a constant
Figure 5 (left). Capturing the visual story.
Figure 6 (above). Sketch models of prosthetic shock absorber.
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printed springs between abutments and prosthetic. 3D scans of facial
morphology allowed us to specify areas to flex and others to remain ridged
using multi-property printing as an extension of anatomical compliance
into a shock absorbing system that could control any sudden movement of
the prosthesis (Fig. 6).
would dislodge itself with ease and had no inherent properties to counter
unexpected contact but couldn’t be firmly fixed for fear of damaging the
surgically implanted magnetic abutments. This led to a series of small bent
metal experiments around suspension and the mount of the prosthesis.
These ideas were integrated into the early prototypes as integral 3D
Figure 7. Explorations into a visual and practical guard modelled from 3D scans.
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Guy, Stevens, Challies and Gillingham
of this would be printed in a very soft and compliant mix to move with the
face and the inner in a firmer grade to support the second part the formal
nose. This would be attached magnetically, and if dislodged revelation
would be of anatomical loss but not disfigurement.
The cavity revealed without a prosthesis is deep and unnerving when
first seen. The fear of public revelation is evidenced in our participant’s
apprehension around activities of close proximity, sport, a crowded bus,
congestion. To minimise the fear of revelation a concept where the nose
had two parts was considered. The first would adhere strongly to the face
and form a visual and practical guard (Fig. 7). The contact boundary areas
Figure 8. Making - 3D printed prototypes. Figure 9. Complex computer generated forms.
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Figure 10. Prosthesis fitting.
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Guy, Stevens, Challies and Gillingham
In a traditional prosthesis the junction between prosthesis and skin tissue
is referred to as the margin, a very thin membrane of silicon that is tasked
with making the face seamless. Facial expression and movement are
counter to this procedure, facial muscles lifting and stretching in reaction
to emotion and task quickly make evident the margin, refuting its intention.
To overcome these issues and emphasise the potential in 3D scanning
and multi-property printing the margin is treated as such. We respect the
conspicuous junction and treat it as a design opportunity where a person’s
freedom to laugh, smile and be active is considered.
With the participants face digitised we were able to construct and print
prototypes that exploited the 3D printer’s unique capacity to print in
range of materials during a singular printing process (Fig. 8). This oers
performance benefits that are only possible with a process that doesn’t
require post assembly and hand craft that could drastically reduce the
cost of prosthetics while improving their performance. We explored
a variety of aesthetic forms for the nose that ranged from complex
computer generated geometries to aesthetics for activities. Many of our
early attempts were propagated within a virtual context of the digitised
face (Fig. 9). We reflected on the context and notion of respectful
transition for our participant in order to alleviate some tangible problems
such as movement and to formalise the aesthetic to that which is known.
Debating success and failure through design practice and the use of many
Figure 11. Colour swatch evaluation for Multi-property printing.
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around aesthetics and performance. We continue this project with further
experiments in multi-property printing including colour and flexion (Fig.
11) and to open up the project to other participants with the focus on
participant as co-designer.
While the project is at an early stage we plan to continue and envisage a
project where people can manipulate and model the design over their data,
select between options and order at a cost eective price. Changing the
visual and performance characteristics of facial prosthesis is an example
of research through design where individuals may take ownership of the
design craft through exploitation of emerging digital technologies within an
international arena.
Acknowledgements
Special thanks to Julian Goulding and Michael Williams (Maxillofacial
Prosthetist/Technologist).
References
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In trialling the prototypes we revisited portraiture photography as a shared
method of visualisation and as a vocabulary to complete our circle of
thought and making (Fig.10).
Outcomes and Continuance
To apply experience and story to concepts we adopted a method of 3D
scanning and computer modelling. In a 3D scan of the face the individual’s
characteristics are captured as data that separates both the logistics
of needing the face to work o and the predisposition to replicate as
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Our participant is now beginning to privately live with the prosthesis,
to reflect outside of the practice and return with more detailed ideas
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Guy, Stevens, Challies and Gillingham
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