RECONSTRUCTIVE SURGERY
Facial deformity reconstruction
Facial deformity may be congenital or acquired through trauma, growth disorders or disease and may involve both hard and soft tissues.
Congenital
Cleft lip and palate are common examples of defects present at birth that may result from an inherited condition. Treatment involves a multidisciplinary approach involving Orthodontists, Maxillofacial Plastic and ENT Surgeons. Treatment is complex and involves multiple operations during the periods of growth.
Trauma
Each year, there are over 500,000 facial injuries in the UK alone, with a significant minority of injuries causing permanent physical or psychological disability or even death. Injuries are most common in males between the ages of 15-25 years and resulting from motor accidents. Much of the remit of maxillofacial surgery is directed towards the treatment of this group of patients with respect to the management of facial fractures and facial scarring using modern techniques such as laser treatment of facial scars and skin resurfacing.
Growth disorders
Disorders of facial growth may affect the hard and soft tissues and are often genetic in origin. Resulting facial deformity often affects the way the teeth meet (dental occlusion). Maxillofacial surgeons and Orthodontists diagnose, plan and manage these patients in multidisciplinary clinics. These deformities have complex relationships with other structures in the face, especially the nose, and may adversely affect the outcome of rhinoplasty if not tackled.
Disease
The commonest diseases to affect the facial area are dental caries and gum disease (periodontal disease). Premature loss of teeth can lead to facial deformity and a face that looks old before its time as muscle tone is altered, jaw bones resorb, lip support collapses, skin wrinkles and furrows are pronounced. Jowling of the lower jaw may develop. The whole face must be considered to achieve optimum surgical success, including use of dental implants and overdentures and/or surgery to the jaws.
Head and Neck Surgery
Head and neck surgery and the resection of tumours leave patients with hard and soft tissue cosmetic defects, as well as functional defects. Cosmetic face lift incisions are now used in the removal of parotid salivary gland tumours to avoid facial scarring. In other cases surgical treatment may be long, complex and associated with significant complications.