Craniofacial Surgery is surgery to the head or face to correct a birth defect or restore normal appearance after an accident or cancer treatment. In some cases, surgeons will move soft tissue and bone from one part of the body to restore symmetry and normal appearance in the head or face. In other cases cheek or chin implants, are used.
Surgery has risks, but you can help minimize complications by carefully following your physician’s instructions both before and after surgery. Discuss with your plastic surgeon the potential risks and complications.
After craniofacial reconstruction, a patient can expect to have some swelling for up to three months while the wound heals.
Cleft Lip & Palate
Facial clefts are birth defects in which the tissues of the mouth or lip don’t form properly during fetal development. When the tissues that form the upper lip fail to join up in the middle of the face, a gap occurs in the lip either one side or both sides known as unilateral cleft lip or bilateral cleft lip respectively. When the palate fails to join up, a gap is left in the roof of the mouth up into the nose known as cleft palate.
Surgery to close the gap in the lip is usually first performed three months after the baby is born. Surgery to close the gap in the palate is usually done at about six- eight months old. Both operations are done with the baby asleep under general anaesthetic and involve a hospital stay of three to five days.
Speech and language therapy may be used to monitor and develop speech. Orthodontic treatment (braces, for example) may be used to ensure that the permanent teeth come through straight and in the right place. Detailed protocol for the management of the child with cleft lip & palate will be discussed at the time of presentation prior to surgery.
Facial Bone fractures
High velocity injuries can cause fracture of the facial bones, a patient can sustain severe facial fractures with very little soft tissue injury. However, vital structures such as the brain, eyes and airway may be involved.
The combined resources of a craniofacial team provide coordinated fracture management which often involves surgery under anaesthesia
Unlike other fractures of the body, facial fractures rarely require urgent surgery, often it is performed after the swelling has subsided or more urgent issues are dealt with, that could be upto 2 weeks.
The principle is to replace the bones in its place and fix it with specially designed titanium miniplates & screws.
Chin & Cheek Augmentation are required if there is lack of definition of chin & or malar bones (cheek bones) due to either congenital cause or because of trauma. Augmentation can be performed either using a patients own bone as a graft (autologous bone graft) or moving the jaw bones forward eg genioplasty or using an implant to augment the bone (eg chin implant, malar implants). Chin implants can be done under local anaesthetic however other procedure usually involves general aneasthetic.
During jaw surgery, a doctor surgically cuts the jaw bone and then permanently repositions it with titanium plates and screws. The procedure dramatically impacts a person’s appearance, and is usually performed through incisions inside the mouth. Distraction is a technique where the surgeon cuts the bone and then inserts a small metal spacer. After the surgery, a small metal key is used to gradually expand the spacer twice a day.
A two-centimeter expansion can take up to two weeks to achieve. After the jaw has reached its final position, the spacer is either left in place until the jaw heals naturally or the jaw is permanently set in place with titanium plates and screws.
Jaw surgery is to correct an over bite or under bite, developmental problem, or final surgery in reconstructing a cleft lip/palate. Patients typically require six months to one year of orthodontia before having jaw surgery. Additional care may be required after the surgery as well.
Reconstructive plastic surgeons are an integral part of the cancer treatment team. After cancer surgery, plastic surgeons are able to restore form and function in many instances. Often the plastic surgeons will do their work during the surgery to remove the cancer, though sometimes a second operation is necessary for reconstruction.
Surgery has risks, but you can help prevent complications by carefully following your physician’s instructions both before and after surgery.
Because patients recuperating from cancer reconstruction surgery are also healing from surgery to remove cancer, the road to recovery can be long. Your doctor will talk with you about what to expect after the procedure.
Facial paralysis surgery
The aim of Plastic surgeon is to restore function, symmetry and appearance for those with facial paralysis, or weakness on one side of the face. They are not only treating the peripheral effects of facial nerve damage but also repairing the facial nerve itself.
Bells palsy is the most common cause of facial paralysis. The condition can impair speech, keep eyelids from closing completely, cause drooling and leave facial features drooping. Treatment may or may not be amenable to surgical treatment.
Every form of facial paralysis is different, as is every patient. Talk with your reconstructive plastic surgeon about what results you can realistically expect after your surgery. Many patients can have significant movement restored to their face, though subtle expressions may not be recoverable.
Discuss with your plastic surgeon to be sure you understand the potential risks and After the wound from your surgery has healed, your doctor may prescribe physical or occupational therapy to help regain further.
Skin cancer is the most common form of cancer. Though we are all at risk for skin cancer, you are at greater risk if you are fair skinned, have a family history of skin cancer or spend a lot of time outdoors. Risk also increases with age.
There are three major types of skin cancer:
- Basal cell carcinoma – This is the least dangerous form of skin cancer. It grows slowly and rarely spreads.
- Squamous cell carcinoma – This form is more likely to spread and become life threatening if not treated.
- Malignant melanoma – Melanoma commonly spreads and can be deadly. A new mole or a change in existing mole can be a warning sign for melanoma.
- Early diagnosis is important for long-term health.
You can lower your chances of developing skin cancer by protecting yourself from the sun. Ultraviolet rays are dangerous, whether from the sun or the artificial lights of tanning beds and sunlamp. Doctors recommend applying SPF 15 every day, wearing protective clothing, staying away from tanning beds and doing your best to avoid blistering sunburns.
The treatment involves surgical removal of the lesion with closure of the wound using surrounding skin or distant skin depending on the extent of defect.
Depending on the size and depth of the skin cancer, your doctor may able to remove the spot in the office using only local anesthesia. In some cases, more extensive surgery and chemotherapy or radiation therapy can be necessary.
Talk to your doctor about what to expect during your recovery and about what steps you can take to prevent a recurrence.