Jorge Franco-Canales is our newest bilignual (English/Spanish) member of the team at the Center for Custom Prosthesis. Jorge has over 8 years of experience in private practice in all areas of General Dentistry and 4 years of experience in Maxillofacial Prosthetics. He has a Doctor of Dental Surgery. He is always innovating and finding new ways to achieve the best quality prosthesis for his patients and has an excellent way with patient care.
Simple Generosity: A Suffering Girl Gets a New Eye
A little girl who suffered a dreadful accident is being given a new hope. Three-year-old Victoria Wilcher was attacked in April by three of her grandfather’s pitbulls at his home in Simpson County, Mississippi. She permanently lost her right eye, and multiple bones in her face were shattered. Other long-term effects of the attack included a loss of hearing in the victim’s right ear, the loss of almost all her teeth and a lack of strength in the jaw.
The latter injuries have affected Victoria’s ability to speak, swallow, and chew food, for which she has needed extensive physical therapy. The story received nationwide press after the girl’s struggle to recover was publicized by her grandmother on her Facebook page, “Victoria’s Victories.” Since that time Victoria’s family has been able toraise over $130,000 through online donations for her medical expenses, many of which are not covered by their insurance. In addition to contributing to the fund raising effort, Las Vegas plastic surgeon Frank L. Stile has helped Victoria by offering to treat her injuries for free. The accident threw the young girl’s family into further tumult in the ensuing time. Victoria’s grandfather, Donald Mullins, and his girlfriend, Rita Tompkins, who had rushed to her aid and were also attacked by the dogs in the process, faced child endangerment charges. Afterward, some dispute was raised as to insensitivity toward the girl on the part of a KFC restaurant, which KFC has denied. Victoria has endured repeated surgeries and a long, painstaking recovery, but according to her grandmother, Kelly Mullins, she has maintained a positive attitude, an inspiring feat for a brave child. And after a long battle, Victoria’s bravery was rewarded.
A New Prosthesis, No Charge
Victoria got a new reason to be happy in July, when the Center for Custom Prosthetics in Naples, Florida provided her with a specially designed acrylic eye on the house. Accompanying her to Florida were Ms. Mullins, Victoria’s mother Anita, and Janet Kellum, a retired nurse from the University of Maryland Medical Center. Ms. Kellum also donated her time and service to the family without charge. There the family met with the Center’s owner, Dr. Raymond Peters, and his wife Susan. Victoria’s family has said that the Peters have become like another set of grandparents to the struggling child. Mr. Peters said the move was motivated by his sensitivity toward the plight that the girl has undergone. “I’ve got a lot of empathy for children, always have,” Peters stated to the press. “I can imagine what that child’s going through because I’ve been in this business long enough.”
Dr. Peters’s experience in the field of prosthetics has been long and rich indeed. He began working in this area while serving in the Navy, as part of the Medical Research Division of the Bethesda, MD Naval Complex. Since that time he has practiced in Washington D.C., Maryland, Virginia, West Virginia, Pennsylvania, and the Carolinas.
In the late 1990s, he retired from medicine and relocated to Florida. Once there, his passion for his work drew him to create the Center for Custom Prosthetics in the laundry room of his house, with the aid of his wife.
“When we moved… he got bored real quickly,” recalls Mrs. Peters on the onset of the practice she created along with her husband, whom she calls “Smokey.” “He told me, ‘As long as I have two steady hands, I need to be helping people.’”
Since making that fateful decision, Dr. Peters has been able to satiate his appetite for service to mankind, along with his associate, Mr. David Trainer — who specializes in prostheses for the nose and ear. The two have treated patients from around the world who come to benefit from their expertise.
This expertise is currently benefiting young Victoria, who has gained not only a new eye but a loving support base in Florida.
The exchange has been mutual; Dr. Peters’s and Mr. Trainer’s practice, while previously highly reputed, has gained a great deal of media exposure and acclaim for its work with Victoria. The harrowing story of a little girl who went through a horrendous and life-changing episode has been deeply compelling to many around the world who are moved by its show of courage, resilience and the power of the simple kindness of others.
Do Prosthetic Eyes Move?
The procedures used today to duplicate the anatomy of the ocular orbit are exact replicas with a direct alginate impression. Any movement in the ocular orbit is transferred to the prosthetic eye with this method.
The wax form duplicating the parameters of the ocular orbit is fabricated and placed on the mold once the trial fitting is accepted after the trial fitting in the ocular orbit.
The mold of the ocular orbit is replicated in stone and the wax form is invested for a final curing mold.
The wax form is removed and replaced with acrylic (methyl-methacrylate), and heat cured to form a hard rigid form, that becomes the integral part of the final finished prosthesis. All proper cosmetics are applied and cured.
The finished product will sit on the face of the implant that was surgically imbedded in the ocular orbit; this implant will have encompassed around it the movement muscles and covered with the conjunctiva tissues. When the eyes move in conjunction with each other, the implanted orbit will follow the movement. With the prosthetic eye sitting upon the face of the implant, it will be pushed in the directions that are initiated by the natural eye. This is how the prosthetic eye gets its movement.
Movement is determined by the position and motility of the implant. This is only possible when the impression of the ocular orbit is correct and the wax form is properly seated to make a mold that replicates the natural ocular orbit.
MOVEMENT can only be ATTAINED WHEN AN IMPLANT IS PROPERLY POSITIONED IN THE OCULAR ORBIT BY THE OPERATING PHYSCIAN.
When an eye maker follows protocol in the manufacturing of a Prosthetic Eye as mentioned in the above technique, he will get MAXIMUM movement transferred to the Prosthesis.
What are Plastic Eyes Made of?
Artificial Eyes (Prosthetic Eye) have for many years prior to the advent of WW 11 been constructed of glass by artisans from Europe. These eyes were made from silica (glass) and fire formed such as a light bulb. They were virtually a vacuum that was fragile and would etch from body acid, causing replacement much more often than a plastic (Prosthetic Artificial Eye).
After WW11 the availability of silica from Europe became very difficult to obtain. Other materials and methods became necessary to fabricate the Prosthetic Artificial Eye. This instituted 3 teams from the Military Dental Departments to develop and solve this problem. These teams consisted of personnel who were experienced in the prosthetic field in working with plastics and art forms. They were chosen from the Dental Prosthetic Schools of Bethesda Naval Training Center and Walter Reed Army Hospital in Washington D.C. They collaborated in their development of the modern day Prosthetic Artificial Eye. This decision was made due to the eye loses of our military at that time. These methods were passed on to the civilian industry by persons who gained this expertise while in the military.
The present day Prosthetic Artificial Eyes are made from (methyl –methacrylate) commercially known as ACRYLIC. This is a synthetic compound that is in two parts. Monomer (liquid) and (Polymer (powder), they are mixed to produce a putty like consistency, then packed in a compression mold to be cured to solidity. This forms the base for the application of the cosmetic duplication of the natural eye. All applications are in a vehicle of the same material, so that they have the same chemical bonding capability. This makes a totally solid product that is resistant to breakage and is malleable enough to allow adjustments and not alter the consistency of the material.
This product when properly cured and finished has proven to (be totally inert) and will not subject the contacting tissue to be affected in any way. This material over a period of time (normally 3 to 5 years) will absorb body fluid that can become adverse to the tissues they contact. This fluid can contain bacteria and acids that will cause irritations and discomfort to the affected area. Replacements are necessary to correct this so as to eliminate these symptoms, and regain a healthy ocular orbit.
Through proper notifications to our patients, this clinic advises these patients to maintain proper hygiene and maintenance, to prevent any problems that can arise from complacency and neglect . They are reminded that the prosthesis must and I say must have their prosthesis cleaned –pumiced and polished every 3 to 6 months to remove accumulated Plaque (protein that builds up on the tissue bearing surfaces).This Plaque is the main cause of irritation to the tissues, such as excessive excreta, soreness, and possible infections.
My advice is that: “Proper Periodical Maintenance will save you a lot of physical and mental discomfort”.
These products are not permanent; they must be replaced periodically.
Hygiene & Care of your Ocular Prosthesis
The proper and proven method in the maintenance of your prosthesis is very simple. These are facts that must be considered.
- All tissue bearing surfaces of the prosthesis are subject to plaque buildup (protein).
- The body treats the prosthesis as an alien and will excrete fluids (tears) to coat it for protection.
- This fluid ,gels and becomes a protective coating against the surrounding tissues (conjunctiva).
- Over time(normally 3 months) the proteins in the fluids will deposit on the tissue bearing surfaces and will act as fine rough grit that will cause irritations and excessive excreta.
- DO NOT remove the prosthesis daily , you will remove the coating and the orbital area in which the eye rests against the mucous tissue will begin excreting to coat this alien (prosthesis).
- It takes 72 hours for the tears to gel on the prosthesis to protect itself. This causes unnecessary excreta.
- The outer part (exposed ) is the area that is subject to atmospheric debris and the area that must be irrigated daily with a saline solution or just plain water.
- Once the prosthesis is coated with this mucous gel, it will rise slightly off the tissues and this is when you get your greatest comfort.
- When you wipe dry your eye socket area during your daily hygiene, always wipe inwardly toward the nose, this prevents pulling on the lower lid.
- This technique can be used as many times as necessary, while not disturbing the inner ocular tissues.
- Removing the prosthesis daily , will put the orbital tissues in a state of flux and will cause excessive excreta.
- When a prosthesis meets these 3 requirements (comfort-cosmetics-motility) in that order you should not have to remove your prosthesis no more than once a month for preventative maintenance.
- At that time the prosthesis can be washed with soap in gently rubbed in a soft washcloth, rinsed and reinserted.
- A badly fitted or poorly finished prosthesis will always give you discomfort and excessive excreta.
- My recommendation is to have your prosthesis serviced (cleaned & polished) by a competent ocularist at least twice a year, and replaced every 3 to 5 years to preserve the health and integrity of the ocular orbit.
A Navy Veteran’s Prosthetic Ear Rehabilitation
Navy Veteran Robert Chesser received a new prosthetic ear, created for him by our Maxillofacial Prosthetist, Dr. David Trainer. The Center for Custom Prosthetics works in close partnership with VA hospitals around the country to provide life-changing rehabilitation for our Veterans.
Trainer, who has been making prosthetic ears, noses and eyes for patients for 35 years, has worked with the VA for the last several years out of his office in Naples, Fla. He drives almost 170 miles each way for at least three visits with the patient before the final prosthesis is ready.
Click here to read the full article by Ed Drohan at the James A. Haley Veterans’ Hospital (Tampa, Florida) Website.
CENTER FOR CUSTOM PROSTHETICS OFFERING CARE CREDIT
We now offer CARE CREDIT, which is a medical financing plan for patients with Custom Eyes, Orbitals, Noses and Ears. This medical financing credit company offers different plans in which patients with Custom Facial Prosthetics can choose between 6 months, 12 months or 18 months at NO INTEREST, if paid in full within the 6, 12, or 18 months. This can be used for to pay for any fees due to the Center for Custom Prosthetics, deductibles or co-insurances that need to be satisfied with their insurer, which are paid to the provider.
It is a simple process that our Practice Coordinator can do for you, and approval can be processed in minutes. Payments are configured on whether you choose the 6 month, 12 month, or 18 month plan., e.g., if you borrow $1000 for 18 months, your monthly payment would be approximately $55.55. This helps the patients as they don’t need to pay themselves the entire amount due for their custom eye, ear, nose or orbital.
Center for Custom Prosthetics had a banner year in 2018. Custom eyes, ears, noses and orbitals were custom fabricated for hundreds of patients, making them feel whole again. In addition, custom refills/replacements were made for eyes, scleral shells, ears, noses and orbitals. Over time, there is “wear and tear” of the custom noses, ears and orbitals, which require that a replacement/refill be done. David Trainer, our Board Certified Anaplastologist, stores the original mold, so that he can mail out a new refill to patient, which defrays the cost of making a new mold every time, and also relieves the patient from needing to visit our offices. He keeps a detailed record of the paint he uses for tinting, refers back to pictures of patients, and is able to reconstruct the custom nose, ear, or orbital prosthesis in a timely fashion.
With Custom Artificial Eyes, or Scleral Shells, replacement can be made according to the insurance plan that you have. However, replacement of a new custom eye or scleral shell, a visit to our offices is necessary. In the event of surgery or weight fluctuations, insurance companies will evaluate the medical necessity, and if there are anatomical changes of the socket, they will approve a new custom eye or scleral shell.
In addition, most of the insurance companies will cover the replacement and/or refill of the custom prosthesis, as long as there is medical necessity. Our Practice Coordinator, contacts your physician for you in order to receive a medical necessity prescription for you. Also, Medicare does replace a custom prosthesis every 6 months, as long as there is medical necessity, and a medical prescription is obtained from your physician. The other insurances will also replace a custom prosthesis twice a year based on medical necessity, and dependent upon your plan.
CENTER FOR CUSTOM PROSTHETICS HELPING VETERANS
Center for Custom Prosthetics has been helping our United States Veterans and Soldiers from all over the State of Florida, and throughout the United States with Custom Prosthetic Eyes, Scleral Shells (an ultra-thin cover over a blind eye), Orbitals, Noses and Ears. These patients either have been wounded from being in the Service, i.e., World War II, Korean War, Vietnam War, etc. In addition, we help Veterans that are suffering from Cancer of the Eye, Orbital, Nose, Ear, cheeks, or Hemi-Facial. Also, any Veteran that have facial burns that resulted in the loss of an Eye, Orbital, Nose or Ear, we can accommodate them as well.
Our Board-Certified Anaplastologist, David Trainer, and Ocularist, Jorge Franco-Canales have crafted these Custom Prosthetics to be fitted to each Veteran as needed. They both travel to VA Hospitals in Florida, i.e.,
Tampa, West Palm Beach, Broward, Miami, and Cape Coral, as requested.
In addition, patients travel to our offices in Naples, FL. Their high degree of excellence in custom fabricating facial prosthetics, and their pristine reputations throughout the medical arena, hospitals and physicians, is why so many patients and Veterans are attracted to our custom facial prosthetic services.
It is a simple process for you, the Veteran. Veterans just need to go to their nearest VA Clinic/VA Hospital and see their Primary Care Physician, Ophthalmologist, or Ear, Nose, and Throat Physician, or Dermatologist and get a Consult from that Physician for a Custom Facial Prosthesis. This Consult then gets sent to the Contract Office, a Quote is sent to them, and then a Purchase Order is sent to us to begin work. This process takes approximately one to two weeks.
Our Veterans so deserve our custom services and we are so willing to be of service to them. In addition to the original Custom Prosthesis that is created for you, a replacement of the Custom Eye or Scleral Shell will be medically necessary to replace in approximately three years (as body fluids absorb into the process and there are anatomical changes of the socket, unless you have had surgery on the socket or lids or have had a weight change, and then it can be replaced as needed. Also, Polish and Cleaning of your Custom Eye or Scleral Shell should be done every six months to remove plaque.
Custom Orbitals, Nose or Ears will be medically necessary to be replaced approximately every six months, due to “wear and tear” of the Custom Prosthesis. These Custom Prosthetic procedures are fully covered by the Veterans Administration, at no cost to you.
Our Center for Custom Prosthetics was founded by a Korean War Veteran, Raymond E. Peters, in Washington, D. C. in the 1960s. After leaving that area in 1996, we reopened in Naples, FL in 2000, and have been serving patients and Veterans ever since. We are committed to helping our patients and Veterans making them feel whole again, bringing tears to smiles.
OPENING IN FORT MYERS ON MAY 1st 2019
Raymond E. Peters, Inc., Center for Custom Prosthetics, specializes in custom Ocular (Eye), Scleral Shell (Ultra-thin Cover over a Blind Eye), Orbital, Nasal and Auricular (Ear) prosthetics. We also custom fabricate Cheeks, Forehead and Semi-Facial. Center for Custom Prosthetics has been in Naples, Florida for nearly 20 years. Our practice has grown immensely with patients coming from all over Florida, across the United States and Internationally. In addition, we serve our Veterans throughout FL for the custom facial needs. Therefore, because of the high volume of patients from the Fort Myers, FL area and from Cape Coral, Lehigh Acres, Punta Gorda, North Port, in Lee and Charlotte counties, we are opening up a new office location at 7680 Cambridge Manor Place, Unit 204, Fort Myers, FL May 1, 2019.
Patients have expressed an interest in our having a satellite office in Fort Myers. Physicians have as well. We chose an area that is nearby to some of the top Ophthalmologists in that area and Oculoplastic Surgeons. This office will be with a complete lab in order to do the work there.
Dr. Jorge Franco, Ocularist, will do the custom fit, Veining and Modification, and delivery of the custom Ocular (Eye) and Scleral Shell (Ultra-thin Cover of a Blind Eye) prosthesis at that office, in order to accommodate the patients in those areas so they do not have to travel to the Naples office.
David Trainer, Board Certified Anaplastologist, will custom fabricate the custom Orbitals, Noses and Auricular (Ears) there as well for patients in the Fort Myers, Cape Coral, Lehigh Acres, Punta Gorda, North Port, in Lee and Charlotte counties. In addition, it would be more accessible for patients coming from Bradenton, Venice and Sarasota. In our short term plan, we are contemplating opening an office in the Sarasota area to accommodate those patients.
David Trainer custom fabricates the facial prosthetics, i.e., Orbitals, Noses, Auricular (Ears) in three different appointments. The first appointment is for the initial fitting/mold to be prepared for the custom Orbital, Nose, or the Auricular (Ear) prosthesis. The second appointment is for the custom sculpting of the Orbital, Nose or Auricular (Ear).
The third appointment is for the tinting of the custom Orbital, Nose, or Auricular (Ear) and for delivery to the patient. David Trainer is also well known for the development of the “disappearing edge” in which the custom facial prosthesis that blends into the face with nearly a seam. These custom Orbitals, Noses, Auricular (Ears) are adhered with a medical skin adhesive. Or patients may choose to the implants/magnets surgically inserted and then the custom Orbital, Nose or Auricular (Ear) prosthesis has magnets intricately placed. Our scheduling is maintained by our Naples Office in order to serve all our patients. Our number is (239) 254-1648. We are excited about our new office in Fort Myers, FL and look forward to servicing all new and existent patients there, as well as at our Naples location!