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The surfaces of a personalized maxillofacial prosthesis were manufactured in a relatively short period of time and at a moderate cost. The surface topography was generated with a Computer-Aided Design system from the Computerized Axial Tomography of a maxillofacial area. The design of the machining manufacturing process, its simulation and verification, were facilitated by the use of a virtual machine tool equivalent to the real machine tool available. Finally, the manufacturing process was successfully achieved by using a conventional 3- axis vertical machining center equipped with a fourth external rotational axis. Using a 3-axis machine tool with an additional axis is less expensive than using a 5-axis machine. There is abundant literature on machining of free-form surfaces using a 5-axis machine tool, but there are few precedents for the manufacturing of this kind of surface using a 4-axis machine. [ABSTRACT FROM AUTHOR]