Inr-Seel and Feature Builder: The Ultimate Utility Players

By Tom Sherman

Tom has been in the funeral industry for over 20 years and still regularly embalms. He is the Dodge representative in central and western Texas.

WhenI speak with people about prep roomsupplies, 99% of the time they expect to have a conversation about chemicals. Cavity, arterial, accessory chemicals, etc. are the expected topic of the conversation, and, of course, we do talk about these things. People are often surprised when I start asking, so what do you have to help in this or that situation? Perhaps in the case of an autopsy, how many locking forceps, hemostats, clamps, and in what varying sizes do you have? Our prep rooms are equipped with so many various items that it can be hard to keep up with all the different things you may need at any given moment. From a roll of good paper towels to a quality lift and the countless little things in between that we may not need every single day, but the day that we need them then we really need them!

Now, I could sit here and fill these pages with lists of all the things a well-equipped prep room could have, but I’m not doing that. Instead, I am going to focus on the two items that I often bring up that people are the most surprised to hear. These items are like the utility players on a baseball team. Sure, Johnny is a fine center fielder, but he’s also a good shortstop, can pitch a little in a pinch, and he hits well. That’s a utility player. These two items I find to be so useful in so many ways that I keep them at home so that I can take them with me to a funeral home if they ask for help and I’m not sure they have them there.

Starting at the top of the lineup, to continue my clumsy baseball analogy, is Inr-Seel. Commonly known around Texas at least as “peanut butter,” this mastic compound is right at the top of the list of items with the most diverse uses in a prep room. When I get phone calls because someone is having an issue with a case, I can say unequivocally that at least half the time my answer is Inr-Seel. So what are the different uses that make this such a useful tool in your prep room arsenal? Well I’m glad I asked, because here goes.

First and foremost is feature setting. Having always been a mouth shaper who uses Webril and Kalip Stay Cream, and sometimes mouth formers when necessary, I was shocked the first time I saw someone use Inr-Seel for the mouth, and intrigued. By using the Inr-Seel instead of cotton there was so much more control for shaping the expression. From building up cheeks from within and being able to smooth them back so as to not look like chipmunks’ cheeks, to having the ability to give someone that pleasant expression, a semi-smile, or as requested by some people, a big smile, there are so many possibilities.

It’s so simple, too. Just place the end of the nozzle (of the two nozzles that come with the injector, round and flat, I prefer flat here) and twist the handle and inject the product into the mouth by the cheek on each side. If it is overfilled just a little, you can start pressing it down and getting it into the shape you want. On cases of people who’ve lost a lot of weight or even become emaciated, this also helps when it’s time to feature build later. Because the cheek has already been physically elevated, we’re not trying to fill the cheek internally past what should look natural. Then still using the flat nozzle, run the Inr-Seel across the teeth and gums. Now we can even out any sunken or raised spots, and even change the expression by adjusting how the lips are angled and turned. Want more of a smile? Move the corners of the mouth up a little, then use your aneurism hook or forceps to press more nasolabial fold beneath the cheekbone. That one act can change the entire look of the person you are working on. Not only that, but it doesn’t wick moisture and promote dehydration the way cotton does.

I had been thinking about this new (to me) use for Inr-Seel since I’d gotten home from the seminar where I saw it done for the first time. So I ordered a new Heavy Compound Injector (more on this later) and a new jar of Inr-Seel. We had both of these in our prep room already but due to lack of care they had become unusable, more on this later as well. My new equipment came in and I was ready to try it out. I loaded my Heavy Compound Injector with Inr-Seel from the jar, got it primed up so the product was ready to come out at the slightest turn of the handle, needle injected the mouth, put in a mouth former to create a base for the Inr-Seel since the decedent had no teeth or dentures, and I went to work. I put the product in the cheeks, in the mouth, on the teeth! And also on the lips, the chin, the eyes, my gloves, oh what a mess I was. But that was OK, because I knew I could take some Dry Wash II and clean it all up, so I just kept going.

Now I was shaping the cheeks, making the folds, adjusting the lips. Inr-Seel was everywhere, I added more, took some out, I could just see the expression I was looking for forming, then I went too far and had to redo it. This took so much time that I decided this is clearly not that way I was going to do things. But dang it, Jack Adams did it and it looked amazing! I knew it could be done. I struggled, I’m not going to lie. But I got there! And the person looked great and I had learned a lesson. A lesson that is fairly obvious that nonetheless people forget all the time. When using a new product for a new technique, it takes time, patience, and practice to perfect your skill. No one went into their first embalming and raised vessels in three seconds. The same applies with any skill that’s worth acquiring. And it is worth it!

Now, that’s the number one thing I think most people use Inr-Seel for. But I know some people who won’t ever care to use it for features. Embalmers have their ways that are comfortable and they’re going to stick with them. As an embalmer myself, I get that. However, that doesn’t mean that Inr-Seel isn’t still a valuable prep room accessory. Another example of its utilitarian use is in autopsy prep. I’ve written about this before so I won’t go too far into it but using Inr-Seel to seal off the exposed vessels in the base of the skull and also to close the seam when the calvarium is reattached is fast, easy and effective insurance against leaks. Just brush a bit of Pore Closer over the Inr-Seel and you’re set.

But wait, there’s more! One of the more common phone calls I get when it comes to an issue from an autopsied case is this: “The ear won’t stop leaking, and I’ve done everything but it just keeps coming.” My answer is always locked and loaded. Do you have your InrSeel handy? Do you also have the compound injector? Take the round nozzle of the injector and place it into the ear canal and fill it with the Inr-Seel. Fill it to the point that it visibly just starts to come out into the ear. Now, press that down with your finger tip, and make sure that the passage is sealed all the way around. This can be done by simply rubbing it in all directions to close any little gaps. Then wipe away the excess that may have gotten onto the visible part of the ear. Dry Wash II will get it right out. Finally, take your Pore Closer and brush it over the Inr-Seel.

If at this moment you don’t have Pore Closer, Aron Alpha can be used too, just be careful to not get it all over. The Inr-Seel itself acts as the plug in the ear, and because of its pliability, it will go deeply into the canal and adhere to all sides. It’s better than just putting in cotton which is limited in how form fitting it can be. Then the Pore Closer on top of the Inr-Seel seals it up and makes sure it stays exactly where you want it. Not only is the problem solved, but it’s reasonably simple and not overly messy. With the right precautions, towels, plastic, etc, it can be done in the casket. The towels and plastic are to catch any liquid that the insertion of the Inr-Seel may push out.

There’s another use here that has to do with autopsies and ears leaking as well. The situation described above used to be the most common one: the ear is simply leaking. But in recent years there’s a disturbing new trend I’ve seen on autopsied cases: the techs are cutting THROUGH the ear canal altogether. So now, you have an ear detached from the canal with a hole that goes to nothing, and the hole of the canal itself is exposed. So now, if you have the misfortune of an ear that is leaking, it is harder to fix from the outside because they may not line up right. Not to mention the problem that the external ear hole may be showing bone or muscle underneath.

In this case what I learned after some time in helping people deal with issues that came later after the embalming, was (and now I’m mixing metaphors) a good defense is the best offense. Now as soon as I see the dissected ear canal, I know that I will have to take care of that before I close and suture the head. By going ahead and filling that canal with Inr-Seel while I have good access to it, and treating the Inr-Seel with Pore Closer, not only have I prevented a potential future leak, but I’ve done it while I have easy access so it’s simple to do. Not only that, but if the Inr-Seel shows through the hole of the ear, at least it looks more like flesh than bone. It can also be touched up with a bit of cosmetic if the shade needs to be darker.

In the case of trauma, Inr-Seel is a player that rarely stays on the bench. Facial bone trauma causes difficulty when it comes to reshaping the face. Feature Builder often doesn’t work here because there’s no structure under the cheeks to hold up the cheek and support the shape. However, using Inr-Seel as the foundation allows us to reshape the cheek from within and if Feature Builder is still needed, it gives a foundation to hold the shape. If the bone structure we are rebuilding is accessible from the mouth then that’s going to be easy. Insert the nozzle from the mouth to the area of trauma and inject the Inr-Seel until it looks just a bit overfilled. Then you can smooth and shape accordingly.

It’s a more involved process if you can’t access the trauma externally, but it’s still possible.

By separating the internal and external lower eyelid, you can take your scissors or scalpel and open an internal channel that will accept the nozzle and then the Inr-Seel to rebuild and restructure the face. We can also separate the eyelid on the upper eyelid and use Inr-Seel to reshape a depression in the forehead and fill in emaciated eye sockets. Like everything else it takes some practice to shape the features and to know how much or how little Inr-Seel is needed. The good news is that it can’t make things worse, it can only help. So if we keep trying and not automatically close the casket, eventually it’s going to be a regular process that inspires confidence rather than trepidation. Keep in mind, when we keep trying, and the word gets around that this funeral home took so and so who flipped his truck five times and got ejected and we were able to see him to say goodbye, but that other funeral home had told us it couldn’t be done, then in addition to helping families mitigate their grief and say their goodbyes, our business will grow and we will get more calls.

Inr-Seel is great for surface trauma issues as well. Tracheotomy stomas are often tough to suture in a way that looks natural, and that’s only if they aren’t so old they won’t even close with a suture. By putting in some Webril to provide a base, we can then put some Inr-Seel on top of that, seal it with the Pore Closer, then add a fine layer of wax on top in order to add natural lines and markings, we have created a natural surface instead of a weird line or unnatural appearance. This same technique can be applied to bullet holes. Suturing or using trocar buttons on bullet holes works great on areas that will be covered with clothes, but on the face or hands this doesn’t look at all natural. By using the same process as with the stoma, we create more natural appearances, so that, with practice, over time, even when families are looking to find the wounds they can’t. I’ve walked into prep rooms and had my friend point to a sutured incision and say, “Look at this, the skin is just falling apart, it’s going to be prone to leaking and the suture is barely holding in the skin.” Here comes Inr-Seel again, off the bench and into the game. If we can insert the nozzle of the compound injector into the incision without undoing the suture, that’s what we do. Fill it with the Inr-Seel until it has raised the area, then press the incision into the Inr-Seel. The compound will fill in the gaps and the suture holds while sealing away leaks. Seal the area with an application of Pore Closer and we’re all set. If the nozzle won’t go under the suture, or if even before the suturing is done we feel this will be an issue, fill the incision with Inr-Seel, then suture on top of it. This needle and ligature will pull the compound into the holes, providing protection.

The other most common call I get where my best utility player gets brought out, is purging. This call mostly comes with bariatric cases or extremely edematous cases. “We’ve aspirated again and again, treated the cavity, done this and that, and they are going out in 10 minutes and we’re out of time.” I know the answer in a best-case scenario is to get to the bottom of the purge, but when I’m getting the call that means that time has run out. As often as not the decedent is already in the casket and purging again when I get this call. So, first question from me is, is your Inr-Seel close at hand? Now, coat some cotton with the compound near the bottom and repack the nose with it. Next, preferably using the round nozzle on the Heavy Compound Injector, fill the nostrils quite a ways with the Inr-Seel and the cotton will act as the base in the sinuses. I use my finger to push it in to where it’s not visible from the surface and also to make sure it has formed a total seal. Finally, here comes the Pore Closer to seal it up. Of course, I make sure the mouth and eyes are glued all the way across. It’s easy on the extremely obese case to miss the corners. The only trick here is to be cautious to not mess up cosmetics if they’re already applied, but in the end it is better to have to reapply some cosmetic than to have to explain to a family what that is staining their loved one’s clothes and casket.

Before moving on to the next most useful but underappreciated prep room item, a note about the Heavy Compound Injector. When I first started in the funeral home we had one but it was old and hadn’t been taken care of. So as far as I was concerned they were bad tools that didn’t work. While we always had Inr-Seel on hand we would have to use spatulas or our hands to apply it for any use. Because of this my use of the compound was fairly limited. It wasn’t until that Jack Adams seminar at Commonwealth Institute in Houston where I saw for the first time how you should take care of it, so I want to mention it here. I still talk to embalmers that think they are useless because they never had one that was taken care of. When you use the injector, whether you’re filling it up or injecting with it, put cream on the threads. Filling it is even easier now that we have the Inr-Seel Quik-Paks. These are 5 oz. packaged Inr-Seel where all you have to do is cut off the bottom and load it into the compound injector. It’s a million times better than the old scoop it from the jar and try unsuccessfully not to make a mess. The cap that covers the nozzle should always be screwed on tight after use and the threads treated with cream. And make sure to clean it after each use. The problems come when the compound itself is on the threads or not covered in the nozzle and dries up, creating issues with the injector’s function. But if you take the simplest care of it, it will last you for life.

Let’s talk about Feature Builder. Of course, it’s for feature building. We all have it, we’ve all used it, we’ve built up temples and cheeks. That was easy. Moving on. But wait, this article is about the underutilized uses of this product, and there are many.

Fingerprint keepsakes have been around for a while. I still shudder at the times in the funeral home when I had to ink print fingerprints to send in for these orders. It was messy, it made smudgy prints, and it had to be done multiple times to get it right. The technology has come a long way on this, with the scanners attached to the phones and all that. But the fingers still have to have readable prints. All too often the fingers being scanned are dehydrated and deflated, making them wrinkled. Even worse are when someone’s fingers have been sitting in liquid, like the inside of a pouch, post-autopsy. We spent so much time trying to get a good angle, squeezing in just the right spot to try and build up the finger, and any other thing we could do to get that print.

One day I was struggling, and mad that I was even having to deal with it, but knowing that it had to get done because, besides the family’s wishes to have those items, it’s revenue to the office. As I turned my body and their hand all around to find the right angle I looked up in frustration and my gaze landed directly on a bottle of Feature Builder. It was an “Aha!” moment that had me kicking myself for not thinking of it earlier. By injecting a bit of it into the fingertip you can bring back the print and have enough resistance to press it onto the ink pad or, in today’s age, the reader. It’s not very much, we don’t want to overfill the finger, this can distort the print and be a problem. Start with less than you think, then, if necessary, add a little at a time until it’s just right. Once you get the right amount down it becomes quick and easy every time.

Naturally, Feature Builder is good for reinflating eyeballs, just make sure to use a smaller gauge needle and hold your finger over the hole so it can set. I’ve talked about this in previous articles, so I won’t go into it much here. The part about holding your finger over the hole till it sets matters. In this business IV holes are the banes of our existence. You don’t even always know that they are there until someone is being dressed! Other times, even if you know they’re there, and you’ve glued them closed, a drip might still make its way out. This is another time when Feature Builder can save the day. Again, using a smaller gauge needle, either inject directly into the IV point, or start an inch to the side of it and inject the Feature Builder toward the spot. In both cases make sure to hold your finger on the injection and IV sites so that it can set. And you’re done. It’s as simple as that. I received a call a couple of years ago from a friend telling me how he had a decedent who had been embalmed somewhere else, and they hadn’t closed the mouth particularly well and it was separating in a weird way. One side of her lips were separated, maybe half an inch. The other side was close together, though not quite there. He had tried to glue the whole thing but the extremely open side wouldn’t move, it was too firm. I asked him had he tried Feature Builder yet, and he seemed perplexed. At the time I only lived about an hour and a half away and it was Saturday so I was home. The bad news was her viewing was in less than three hours. I jumped in the car, hightailed it over, grabbed his Feature Builder and a 22 gauge 1” needle.

Here’s where it got tricky. If I were to just start injecting, then the lips would merely swell up and look big. They might not even go up to touch. I took an aneurysm hook and held the handle firmly below the lip, pressing the mouth against the teeth. Then I started slowwwwly injecting the Feature Builder so the lip was filling in a way that stayed flat but still went upward toward the top lip. Doing this I was able to get it almost there. So I went to the top lip and did the same thing and the lips met. He was able to put some cosmetic on and put her in the casket, and she was ready about 20 minutes before the family arrived.

Now I know the question everyone wants to ask is why not just have used wax? Well, we probably could have, but the amount of wax we would have had to use would have been like building an altogether new half of a mouth. The feature building also ended up looking more natural. I’ve said in a previous article that Feature Building lips when a family thought someone’s lips were too thin isn’t particularly difficult. But it does take practice and patience for it to be easy and fast. If someone is just starting out trying this technique, I cannot repeat often enough to inject slowly and only a little at a time. It is easier to change direction and add more, than it is to try and squeeze it back out. Not everyone needs to look like they got collagen injections yesterday! These are only a few of the less common functions of Inr-Seel and Feature Builder. We discover new ones all the time when something comes up and we have to innovate. These are my favorites though, and the most common answers to the phone calls I receive asking for advice. I’ve said it before, and I’m saying it again, my favorite part of writing these articles is that I know that now I will see people who tell me their interesting techniques and tricks and I’ll learn even more. I hope that this has added some weapons to your arsenal and also will be a conversation starter to learn even more.