Surgical repair of three-dimensional structure defect in facial skeleton is remarkable difficult and unpredictable. Particularly, complex bone defects are difficult to reconstruct accurately. Purpose Traditional reconstruction of bone defect in the facial skeleton involves harvesting of free bone flap. This causes morbidity and complications. To avoid above, particularly in midface area, bone defect is often repaired using alloplastic implant. However, several surgical problems exist. The exact positioning of the implant is difficult. Another difficulty is to mimic the shape and thickness of the implant to restore the volume and complex 3D shape of original anatomic structure. Reconstructive surgery should be evolved into a multidisciplinary field where surgeon works in collaboration with scientists and engineers. One such new field is individual CAD CAM rapid prototyping. Material and methods The process is divided into several stages. The image of the anatomic site of defect is first created using CT, the data is converted into CAD software to develop a 3D digital model. Digital implant is designed onto digital model and finally the precise and equivalent solid implant is fabricated using rapid prototyping (RP) technique. Results 15 patients were included into this prospective study, 12 males and three females. Reconstructions were carried out because of either trauma or malignant tumour resection. The average age of the patients was 42 years (25.9–67.2). Patients had defect in two or more walls of the orbit or part of maxilla. Sites of reconstruction were either orbital walls alone or combined orbit – maxillary defect. Results are presented. Conclusions In the present report, this concept is introduced: Orbit – maxillary defects are repaired and the bony continuity and form restored with CAD CAM individual titanium onlay implant. The defects can be determined and the implant can be manufactured accordingly to restore original volume as well as the original complex shape.