Epitheses are aesthetic prostheses made of materials foreign to the body to compensate for body defects. Especially body defects in the face are corrected by epitheses. This reduces the suffering of accident victims and tumor patients who have lost parts of the face.
What is an epithesis?
Some patients still prefer glued-on epitheses today because this method of attachment spares them the expense of surgery. Plastic surgical epitheses use material foreign to the body to compensate for body defects. The term “epithesis” is derived from the Greek and literally means “the attached”. The first epitheses are said to have existed among the Egyptians. In the Middle Ages, epitheses were pictured for the first time and in the 18th century, modern epithetics was preparing. At that time, the dentist Nicolas Dubois de Chémant molded the first epitheses of the nose and chin, all of which were made of porcelain. Later, materials such as rubber, aluminum and silicone were also discovered for epitheses. Epithetics is mainly under the star of aesthetics. The epithesis is usually intended to alleviate psycho-social stress after disfigurement. The primarily aesthetic aspect distinguishes an epithesis from a prosthesis or an orthosis, which must meet primarily functional requirements. Most frequently, epitheses are made for the facial area, so especially after accidents or operations.
Forms, types and styles
Epitheses can be made of various materials that are foreign to the body. For example, glass, as well as plastic, porcelain, metal or rubber can form the basis. Which material is used depends primarily on the part of the body that is to be replaced by the epithesis. An epithesis can be fixed in four different ways. For example, an epithesis of the eye in the empty eye socket can be attached to existing anatomical structures. However, eye and nose epitheses can also be attached mechanically. They can then be attached to eyeglasses, for example, which makes them easier to put on and take off. However, since this type of epithesis is taken off and put on with the glasses every day and can slip off the nose during sports activities, for example, it is not the popular model today. The third fastening option is the fixation of the epithesis by chemical means such as medical glue. Such an approach can be implemented relatively quickly, but it can irritate the skin. The fourth type of fixation involves attaching the epithesis to a titanium implant just under the skin. This type of anchorage is now the most common in modern medicine. The epithesis carrier, the point where the titanium implants pass through the skin, must be cleaned regularly to prevent inflammation and other complications.
Structure and mode of operation
Some epitheses adapt themselves to a body defect by their shape and thus remain attached to it without any aids. If such an epithesis is out of the way, it must be mechanically anchored as described above. Usually, the doctor implants small metal pins in the bone for this purpose. These metal pins protrude from the patient’s skin at the end of the implantation like tiny anchoring posts. The epithesis can then be fixed to the metal pins. Final fixation can be achieved by magnetic components in the epithesis, by bars, press studs or even staples. A crucial question in this context is, for example, whether the patient wants or should remove the epithesis regularly. In this way, the patient’s individual needs are taken into account during planning. The patient’s life situation also influences the final type of attachment. For example, a young high-performance athlete often wants stability and support from an epithesis. Seniors in a quieter life, on the other hand, often care more about the ease of use of the epithesis than the stability of the attachment. Even today, some patients prefer glued-on epitheses because this type of attachment spares them the expense of surgery. However, because of its low retention force, medical adhesive is now only recommended for small and lightweight epitheses.
Medical and health benefits
The benefits of an epithesis are primarily seen in the social integration and improved mental health of patients. People with facial defects in particular often withdraw socially out of shame and thus suffer psychologically devastating consequences due to the disfiguring defect. However, epitheses are not only intended to reduce the amount of ridicule and disturbance that patients receive from other people. They should also regain security and increase their own self-worth. For social interaction and thus interpersonal dealings, the face in particular, with its individual parts, is an irreplaceably important instrument of expression and is even treated as a kind of calling card. Epitheses give back to the affected person the security in social interaction. Social interactions and interpersonal relationships are thus facilitated for the patient. The risk of isolation after disfigurement can therefore be reduced via epitheses. Psychological consequences are thus reduced and the quality of life of those affected increases. This aspect also plays a role for prostheses, but is even more important in the field of epitheses. Accordingly, epitheses have health benefits primarily in the context of mental health.
