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Craniofacial Reconstruction

Craniofacial reconstruction is surgery to repair deformities of the face and head.

In general, because this involves the skull (cranium), as well as the brain, nerves, eyes, and facial skin and bones, both a neurosurgeon and a plastic surgeon are required.

Who’s a Candidate?

Primary candidates for craniofacial reconstruction are those with birth defects; patients who have received severe injuries to the head, face or jaws; and those with deformities caused by the removal of tumors. Of the birth defects treated, some of the more common include: Crouzon’s disease, characterized by widely spaced eyes, defective bone development, protrusion of the eyeball, a wasting away or decrease in the size of the eyeball and squinting; Apert’s syndrome, a condition marked by a peaked head, as well as webbed fingers and toes; and hypertelorism, marked by abnormal width between the eyes.

What are the Risks of Craniofacial Reconstruction?

As with any surgery, craniofacial reconstruction patients run the risk of infection and excessive bleeding; and as with any use of anesthesia, difficulty in breathing and an adverse reaction to the anesthetic agent may result in some patients. Additional risks specific to craniofacial reconstruction include permanent scarring, partial or complete loss of bone grafts, nerve damage or the need for additional surgery.

Preparing for Surgery

As common sense would dictate, the patient should eat sensibly, get plenty of rest and cultivate a positive attitude prior to surgery. Discuss the surgery with family and friends, as well as anyone else who might be affected by the patient’s absence during convalescence. And, of course, consult with the physician regarding any further advice or prohibitions and any questions you might have.

The Surgery

The surgery, which may take from four to 14 hours, is conducted under general anesthesia. Some of the facial bones are cut and repositioned to create a more normal structure. Bone grafts may be taken from the ribs, pelvis or skull to fill in spaces where bone has been removed from the head and face. Small metal plates and screws may be inserted to hold these bones in place, and the jaw may be wired together to position the bone grafts.

If the surgery is expected to cause excessive swelling of the face, mouth or neck, an airway tube is often used. This tube may be placed directly into the airway via incision to the neck, thereby facilitating breathing.

After Your Surgery

Depending on the extent of the surgery and the need for post-surgery monitoring, the patient may spend the first two days following surgery in the intensive care unit. Barring complications, the patient will be able to leave the hospital within the first week. Complete healing and resumption of normal activities may take up to six weeks.