This paper presents an improved biomechanical model for the prediction of the soft tissues in the plastic surgical simulator. The new model is built on nonlinear finite mixed-element method (NFM-EM) in which the internal soft tissues (muscles and fat) are discretized into tetrahedral solid elements and the skin tissues into triangular shell elements, which distinguishes between the internal soft tissues and the skin in their geometrical structures, and addresses the non-homogenous problem of the facial soft tissues in their biomechanical characteristics. Moreover, after the investigation of the three different nonlinear strain-potential models, the biomechanical characteristics of the skin and the internal soft tissues are modeled with the most suitable one. The quantitative validation and the comparative results with other models illustrated the effectiveness of the approach on the simulation of complex cranio-facial surgery.
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