Facial reconstruction surgery repairs damage from injury, cancer, and birth defects. Different facial reconstruction surgery techniques are used for the skull, nose, ears, and lips. These surgeries might correct deformities present at birth or damage to facial features from an accident. Other facial reconstruction procedures might be done for cosmetic reasons to improve appearance.
Children born with a cleft lip or palate typically undergo facial reconstruction surgery to close the cleft. This operation is generally performed when the infant is about three months old. If the palate requires repair, the operation typically is done later, but before the child turns a year old. The surgery closes the cleft and reconstructs the lip so it appears more normal.
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Ear reconstruction surgery is called otoplasty. It might be done on part or all of the ear to correct birth defects. Micotia surgery creates new ears from cartilage and tissue taken from the patient’s body; the cartilage generally comes from the rib cage. Otoplasty might also be performed to pin back ears that stick out and appear excessively large. Cartilage is sometimes removed to reshape ears in this type of facial reconstruction surgery.
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When skin cancer affects the face, head, or neck, Mohs surgery represents a treatment option. This operation was named for the doctor who developed the technique of removing thin layers of skin to excise all cancerous tissue. The operation is commonly done with a local anesthetic and requires no hospitalization. Lesions are removed and examined under a microscope layer by layer until all the cancer is removed. Microsurgery is usually done later to repair any deformity to the face from Mohs surgery.
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If trauma damages facial features, a doctor’s primary concern typically centers on the airway, circulation, and the possibility of brain damage. He or she might hold off tests to determine the degree of facial reconstruction surgery needed until the patient is stable. Once that occurs, a computer tomography scan shows whether the patient needs bone grafts, plates, or stabilization of small bone fragments. Surgeons typically try to perform all the repairs in one operation, which might include implants to fill in missing tissue.
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Tumors in the skull rarely grow into the facial region, but when they do, they require surgery. This is considered a complex procedure because nerves and numerous blood vessels are involved. It might require the assistance of a neurologist and neurosurgeon to minimize loss of function.
Mentoplasty repairs deformities of the chin to improve appearance. It is commonly done at the same time as rhinoplasty, often called a nose job. Rhinoplasty corrects injuries to the nasal area that impede breathing and may be done for cosmetic reasons also; it is considered a difficult surgery. Other cosmetic facial reconstruction procedures include a facelift, liposuction to remove excess fat, a forehead lift, and eyelid lift.