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We require a doctor's order or prescription in order to begin the prosthetic treatment. Your doctor can fax to: 214-363-2092.

The fabrication of our custom prostheses relies heavily on anatomical accuracy and precise color matching. Each step of this process is tailored to the patient and their needs, so it is impossible to create a prosthesis of our quality remotely. However, once a prosthesis has been fabricated, it is possible to make minor repairs by mailing in your prosthesis to our clinic after confirming with us that the repair is possible. Additionally, if you are located a substantial distance from our office and would like to have a virtual consultation before starting the process, call the clinic to schedule.

Our practice fabricates the prostheses in our clinic’s on-site lab. This gives us control over each step our process, therefore, assuring a quality result that meets our standard of excellence. As an Anaplastology clinic, making these types of prostheses is our sole specialty. We have been dedicated to creating facial and somatic prostheses for over 18 years. Receiving formal art training, our clinicians have the ability to apply these skills in the medical world. Our priorities lie equally in the artistic finesse of the prostheses and your health.

Upon delivery of the final prosthesis, you will be given a set of written instructions that we will go over thoroughly in the office. If at any point you have additional questions, you can always email or call our office. Follow-up appointments are important to maintaining proper fit, color, and comfort. However, they may not be necessary in pre-determined intervals. If your prosthesis is causing irritation, fitting improperly or the colors are not matching as well as they used to, it may be time to schedule a follow-up to address these issues. Each patient has anatomy and a daily routine that is unique to them and can result in variability in wear and fit over time.

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Mosaic Prosthetics General Care Routine Instructions

There are several ways to retain a prosthesis. However, not every patient is a candidate for all types of retention depending on their anatomy, lifestyle, type of prosthesis, and prior health conditions/treatments.

Adhesive Retention:

This is the most common type of retention that we use in our office. Adhesive retention is ideal for someone who does not wish to undergo additional surgeries, needs a partial restoration of anatomy, or has compromised bone in the affected area. We offer several types of adhesive and can help match you with an adhesive that is conducive to your lifestyle and comfort. Some common examples of prostheses compatible with adhesive retention are ears, noses, and orbitals (this is not a comprehensive list).

Implant Retention:

Implant retention is facilitated by bone anchored implants that are placed by a surgeon. These implants can take several months to osseointegrate (bone grows into the threads of the implant screws) but can be easily attached for those with lower motor function or visual impairment. Once the implants are fully integrated and the final abutments are placed, we can begin the actual fabrication process. These abutments and skin around the implants require regular cleaning by the patient as instructed by the surgeon or anaplastologist. This type of retention is not always possible for those that may have compromised bone (i.e. irradiated bone). Some common examples of implant retained prostheses are ears and orbitals (this is not a comprehensive list).

Mechanical/Anatomical Retention:

This type of retention is dependent on the prosthesis being able to interlock with existing anatomy. Upon evaluation with your trained Anaplastologist, we will determine if there are any anatomical shapes that can be utilized in the design of your prosthesis to aid in positioning and locating the device. An example of this would be using a bulb-like structure to retain an orbital prosthesis in a well healed eye socket or a glove style prosthesis to restore missing digits.

Suction Retention:

This type of retention is most common in restoring digits. Often with a very precisely fitting tubular shaped prosthesis (like a finger), water or an approved lubricant can provide enough suction to retain the prosthesis without the use of adhesive.

*Some prostheses can also be attached to acrylic framed glasses.

If you are seeking an implant retained prosthesis, it is very important to discuss with your surgeon if you are a candidate. Often, those who have undergone substantial radiation therapy may have significantly compromised bone. Make sure you talk with your surgeon about the risks and potential complications associated with placing implants to help determine if this is an option for you.

Our clinic does not place implants. This must be done by a surgeon. However, we will work together with your surgeon in deciding ideal implant location. Ideally at least two implants are placed in order to support the weight of the prosthesis without the additional use of adhesive. However, three implants are preferred for strong retention. You will also need to have a consultation with us before having the craniofacial implants placed, so we can collaborate with your surgeon.

Our fabrication process requires the patient to be present for several appointments. The number of appointments can vary depending on retention method, type of prosthesis, and complexity.

Below is a rough outline of our process.

Consultation:

This appointment can be done virtually or in-person. We will discuss your case and answer any questions that you may have about our process. We will also talk about retention options and begin to formulate a treatment plan. For those who have an in-person consultation, if you wish to proceed, we can start with impressions on this day. If you decide to proceed at a later date, or you did a virtual consultation, impressions will need to be taken at a separate appointment.

Surgical Planning (for implant retained prostheses ONLY):

During this appointment, we will decide where the ideal locations for the implants are. If you choose to do implants, it may take several months for the implants to osseointegrate. Proper integration is crucial to the success of the implant! We cannot proceed with the next steps until you are fully healed, released by your surgeon and approved by your anaplastologist to take a new impression.

Sculpting/Color Matching:

Sometimes these appointments are combined, but are sometimes separate. This will depend on the complexity of your case and availability. During this appointment, we will fit a wax mock-up of your prosthesis to your anatomy and make any necessary adjustments. After we are happy with the fit, we will continue sculpting. If you are receiving an orbital prosthesis, we will also need to adjust the gaze (direction that the eye piece is looking). The color matching portion of this process consists of mixing custom colors designed to match your skin tones as exactly as possible.

Eye piece painting (for orbital or upper facial prostheses ONLY):

At this point, we will paint the eye piece or ocular to match your unaffected side (if applicable). This will help capture all the nuances in the color of the iris. Some people bring their own ocular that was fabricated by an ocularist. If this applies to you, this appointment is not necessary.

Nail Coloring (for somatic protheses ONLY):

Protheses with specialty nails may require an additional appointment to custom shape and paint the nail.

Delivery:

This is the final appointment in our process. We will tint the prosthesis with extrinsic color to further create a convincing restoration. Tinting can be done again at a later time if the color starts to fade or not match your skin tone anymore. If you have an orbital prosthesis, we will apply or paint on eyelashes or brows at this time. During this appointment, we will also go over all care instructions and teach you how to apply and remove your prosthesis. This is also when we tell you to not let your dog eat your prosthesis 😉

Disclaimer: There are some somatic prostheses that require the fabrication of a test socket prior to final fabrication. If this applies to you, we will talk to you about it during your consultation.

In some cases, we can get most of the appointments done over the span of a week for those traveling.

Our office generally does not fabricate prostheses for children under the age of 5 or 6. It is important to note that children grow very rapidly and may need many versions of the prosthesis until they are done growing. We recommend waiting until after puberty if it is not feasible to redesign the prosthesis every 2 to 3 years based on skeletal growth.

If your first appointment with us is a virtual consultation:

Upon scheduling, you will be sent our new patient paperwork. This must be filled out and returned to our office before your consultation. If you wish to proceed with impressions at your next appointment, we will need an order/prescription for the prosthesis from your doctor.

If your first appointment with us is in person:

You will be able to fill out all new patient paperwork in the office. If you choose to proceed with impressions at the time of your consultation, we will need a written order/prescription for your prosthesis from your doctor prior to the consultation.

If you wish to proceed with impressions at a later appointment:

We will need a written order/prescription for the prosthesis from your doctor prior to the impression appointment.

Additionally, for anyone wanting to file a claim with insurance, we will need clinical notes pertaining to the need for restorative services from the same doctor that provided the written order. These clinical notes must date within the last 90 days.

*Please note that your prosthesis does not need to be ordered by your diagnosing/resecting doctor. Often times, we are working with our patients’ primary care physician.

The only step in our fabrication process that can be done virtually is the initial consultation. Due to the customized nature of our prostheses, we cannot proceed with fabrication virtually.

During your consultation with the anaplastologist, we will discuss your case and answer any questions that you may have about the process. This includes but is not limited to retention methods, our process, lifestyle changes associated with a prosthesis, general insurance questions, questions about DME (durable medical equipment) and how we are different from your traditional healthcare provider. In-person consultations may be able to provide a more comprehensive assessment of your case, as the anaplastologist will be able to see the affected area in person from all angles.

Most health insurances, including Medicare and Texas Medicaid (for ages 21 and under) allow for reconstructive prostheses. Our office also works with the VA and workers compensation to provide our patients with prostheses. During your consultation appointment we formulate a treatment plan and discuss the applicable fees and payment policies. If you decide to proceed with the agreed upon treatment plan we can submit for prior authorization to your insurance, help determine your benefits, and file your claim upon completion of service.

With proper care, a prosthesis can last between 2 to 4 years. There are several factors that can contribute to the longevity of your prosthesis, such as; sun exposure, cleaning methods, lifestyle, frequency of use, retention method, type of prosthesis, hygiene, and anatomical stability or soft tissue changes. It may be time to consider replacing your prosthesis if you notice substantial color difference, an ill-fit (can be caused by weight gain, loss, etc.), substantial growth (common in children and adolescents), or it has become unhygienic. If your prosthesis is still fitting correctly, a new one can be made from your existing mould that we keep on file. If your prosthesis is no longer fitting and cannot be modified to fit, it is time to start over with a new mould that is designed to accomodate your current anatomy.

A prosthesis is not a permanently fastened device; it is an external removable device. It must be removed daily for sleeping. Removing the prosthesis nightly also allows the skin beneath to breathe and air out. Maintaining the health of your skin is important in assuring proper fit and avoiding irritation.

The lids of an orbital or upper facial prosthesis will be unable to move or blink.

A nasal prosthesis can help restore natural airflow by closing off, humidifying and protecting the nasal mucosa.

We have seen patients who are dissatisfied with a prosthetic restoration made at other facilities. During your consultation we can address your concerns and help determine what the best course of action is to remedy your concerns in a new design. We are happy to serve as a second opinion with no obligation of further treatment.