F&P 431-432-Forma full face mask

Herein I mostly discuss differences – especially interchangeability of parts, but also describe some unique features and drawbacks compared to other masks.

Looking at photos of the 432’s cushion & seal compared to my 431, it appears that they’ve changed from the single-piece varying- thickness silicone cushion-seal to a foam piece behind a separate thin silicone seal. The old cushion-seal is somewhat stiff in the thicker area so feels hard, perhaps they should have tapered its thickness. I can’t see from photos if the new configuration would be less prone to flutter from air leaks (the original configuration lacks a subtle design feature some other brands have). Users who have used both were quite pleased with the 432.

According to one source, the 432 cushions/seals will fit all but the earliest 431 masks, no detail of how to tell which version you have but I suspect if you have the 431 that came with S, M and L cushions the 432’s will fit. However, another source says that 432 cushions will not fit the 431 shell but 431 cushions made after April 2006 will fit the 432 frame (MD727’s review in this forum in 2006 suggests to me that the 432 cushion will not fit the 431.). My first box had lot number 051220, my second 060329, both model number HC431A (note the A) and says it is for CPAP or bi-level ventilation.
One user in this forum used tape to try the 432’s cushion on the 431 shell.
One report says some users have mixed cushion & seal sizes of the 432’s design.
F&P’s web site uses different p/ns for cushion and seal of 432 versus Forma.

F&P’s web site has a “fitting guide” for the Forma and Zest but no instructions, the Zest is too small even if I cut on the outside of the line, it appears that the height increases from S thru XL of the Forma are approximately ½”, 3/8”, and ¾”. It also has a “fitting guide” for the 432, which is mostly an illustration of how to don the mask but has an illustration of proper cushion size – top approximately level with centre of eyes.

But beware that at some point F&P renamed sizes, perhaps early in 431 production. Information is not clear, one source says Small was the size of current Medium and Standard the size of the current Large (appears they added a new Small size below the current Medium, and that the current M & L are different pns than the former cushions). Apparently there is also an XL for the Forma which I guess might fit the 432 shell (typical marketing hype talks of the cushion design as new to the Forma, but often they said they same for the earlier model). They really need a larger shell as well, it simply is not tall enough for me, and they may need a Petite as well – I think they only have one shell, sold complete with S-M-L cushions (originally they only had two sizes of cushion, probably added S), whereas they probably should have at least two (a larger one that they could package L & XL cushions with, and a smaller one that they could package P & S cushions with– that could makes three since they already have the in-effect Medium shell mold and package S & M & L cushions with that shell. F&P should to capitalize on their strengths instead of going cheap on sizes and forehead adjustment. (Like some other suppliers, they try to get wide fit to reduce middleman stock needs, but simply are not there yet in design.)

F&P’s masks use a sliding mechanism to allow movement between headgear and mask under sideways force, to reduce seal disturbance, and a quick-release cord to release the headgear-mask latch. The latch configuration is somewhat easier to insert than other brands’ designs. Unfortunately the headgear attachment on the other side is an integral plastic hook which is not strong enough for durability – I bypass it.

These masks have a shell and cushion configuration that attempts wit significant success to be more adaptable on the bridge of the nose. However the 431 still feels rigid, and like most interfaces these masks work quite well for some and not well for others (earlier reports in this forum from 432 users indicate that it is hard on delicate skin).

The headgear is four-point with a lateral over-aft-crown lateral strap not on most mask brands (but needed with this mask to match the chin lip). I read that the 432’s headgear has wider stretchier straps , but is interchangeable.

The Forma variant adds broader forehead contact, double the contact surface area and perhaps additional resistance to twisting of the mask on the face, but still not adjustable for depth which I consider essential. (They’ve improved their silicone pad design so it doesn’t bottom out as easily. The Forma uses two of it, the earlier models one, and it is on their nose masks. I use a foam-in-terrycloth pad enveloping F&P’s pad.)
They’ve also fiddled with configuration of the upper vent hole array, perhaps to reduce flow speed by venting over a larger area and be less prone to clogging.

Part 2 (in expectation that the posting problem was due length of post):

An interesting feature of the 431-432-Forma design is that it has two vent methods. In addition to the array of holes high in the shell there are two flaps at an angle in the hose swivel, oriented so that exhaled air flows out two holes when it overcomes machine pressure but those holes are closed during inhaling. I like that. And note it gives redundancy of venting, to a significant degree, as a full face mask covers all breathing orifices (and that F&P design has a chin-restraining lip). (For reasons I have no idea of, the anti-asphyxiation swivel part number is different in Australia than the rest of the world, and the parts listing warns not to use with “non-invasive ventilation models” whatever those are (I’d interpret “invasive” as intubation, or perhaps forced breathing like BiPAP – the regular F&P masks come with the anti-asphyxiation swivel securely attached.)

F&P also have an in-line oxygen tubing adapter for their masks.

Some good features, looks and feels like a quality product, I much prefer it to the ResMed product I tried, but as with every interface I’ve used it has some serious flaws.

(I unwisely purchased an extra 431 when I found it much better than the Ultra Mirage (one sealwas as much half the price of the entire mask with three seals!), now that I’ve advanced far with my modifications to the ADAMS pillows interface (including CONJO headgear) the 431 and the best nose mask I have seem crude (uncomfortable force locations and much more leak prone). I’m not going to upgrade as I rarely use the 431, my budget is limited, they have more work to do, and upgrading would be the time to survey the market including checking new entrants and what Hans Rudolph has (in Europe they had a way of customizing the shell using a projected light grid and camera). One need in the business is for custom modification of shells to better suit face contour. I read of someone who paid several hundred dollars for such, and was happy with the result, I’m tinkering with frugal measurement methods.)

PS: A set of “LINKS to F&P FlexiFit nasal mask and 431-432 FF topics” has been provided by “rested gal” at viewtopic/t14594/LINKS-to-FampP-FlexiFi ... opics.html. (The “Flexifit” is the 405-407 line, apparently superseded by the Acclaim2/Zest – marketing from A 2 Z?

PPS: If you are digging around F&P’s web site, check out the file “The fundamentals of sleep and OSA” which contains example breathing waveforms.

BigNortherner wrote:Part 2 (in expectation that the posting problem was due length of post):

An interesting feature of the 431-432-Forma design is that it has two vent methods. In addition to the array of holes high in the shell there are two flaps at an angle in the hose swivel, oriented so that exhaled air flows out two holes when it overcomes machine pressure but those holes are closed during inhaling. I like that. And note it gives redundancy of venting, to a significant degree, as a full face mask covers all breathing orifices (and that F&P design has a chin-restraining lip). (For reasons I have no idea of, the anti-asphyxiation swivel part number is different in Australia than the rest of the world, and the parts listing warns not to use with “non-invasive ventilation models” whatever those are (I’d interpret “invasive” as intubation, or perhaps forced breathing like BiPAP – the regular F&P masks come with the anti-asphyxiation swivel securely attached.)

If you are experiencing air coming out of the "Anti-asphyxia" valve when you are exhaling you have a faulty mask. Air SHOULD NOT come out of this valve while the PAP machine is in operation, the flaps are suppose to remain in place blocking the holes. I'm assuming that you are famailar with the operation of an anti-asphyxia valve so I won't go into detail, but rest assured that it is not designed to be a second vent method.

Please look at the subject device yourself, see how the flaps are oriented and their position relative to inlet air flow path and the holes in the side of the device.

Please consider what happens when the air stops flowing from the CPAP machine.

BigNortherner wrote:Please look at the subject device yourself, see how the flaps are oriented and their position relative to inlet air flow path and the holes in the side of the device.

Please consider what happens when the air stops flowing from the CPAP machine.

I have looked at the device myself, I look at it every night when I put it on. Infact I have looked at the 432 for 3 years and the 431 for longer than that since i sell them and fit them on patients everyday.

I have considered what happens when the air flow stops. My issue was never with the fact that air flows out of the anti-asphyxia valve when the pap machine is off and there is no air flow. My issue was with your statement that the anti-asphyxia was a "second vent", it is not a second vent. I will state again, if you have air coming out of the anti-asphyxia vale WHILE your PAP machine is blowing air than you have a faulty anti-asphyxia valve and need to get it replaced. It is only suppose to be open to allow air flow out the holes when the PAP machine is off and there is NO air flow.

akcpapguy,
I assume you've tried a Resmed UMFF. Can you say which of the UMFF's drawback is solved for you by the F&P line?

I'm having problems with a ResMed UMFF medium - I think it has to do with my chin being somewhat receding - so the side part really digs into my cheeks, while either the bottom or the top leak. Or hurt me. I wonder what mask may be better...

Thanks,
O.

The largest problem for me personally with a FFM was the bottom of the seal sliping into my mouth at night. The F&P masks solved that for me with the chin cup design. For some of my other patients (sorry RG) it solved the pressure across the bridge of the nose problem. The F&P FFM's are very stable masks on the face even without the forehead support making contact with the skin. The forehead support on my Forma doesn't touch my skin unless it is pushed there by my pillow when sleeping on my side. I was never able to use the UMFFM due to the same problem you are having, always alot of pressure on the check bones and a bruised feeling when I awoke in the morning.

Thank you, akcpapguy, that is very helpful.

O.