Burns, trauma, cancer surgery and illness can affect the face both in appearance and in function. Damage to the bones and soft tissues of the face can affect the ability to blink, smile, talk or eat. Facial plastic surgeons can reconstruct facial structures to improve function and help a person be more comfortable with their appearance.
- To rebuild structures of the face, a facial plastic surgeon may use tissues from the person’s body, such as a microvascular free tissue transfer, or “free flap,” where the surgeon takes skin, bone or muscle from one part of the person’s body to reconstruct new facial features.
- This type of surgery is called “microvascular” because the tiny blood vessels of the transplanted tissue must be carefully reconnected to new vessels to ensure success.
- Where this approach is not possible, implants and prosthetic devices can help restore more natural-looking contours and features.
Types of Facial Reconstruction Surgery
Facial reconstructive procedures include the following:
- Reconstruction of the structures of the face, head and neck after cancer surgery
- Nasal reconstruction
- Cleft lip and palate repair
- Ear reconstruction
- Facial trauma treatment
- Facial reanimation
- Microvascular free tissue transfer
- Nose reconstruction
- Scar treatment
- Mohs surgery for skin cancer and reconstruction following surgery
- Skull base surgery
Facial Reconstructive Surgery: Procedure and Care
Facial reconstruction procedures can take place in the surgeon’s office-based surgical facility, an outpatient surgery center or in a hospital.
Before the surgery, the surgeon will conduct a thorough history and examination and assess whether to use the person’s own tissue, such as skin or cartilage, to reconstruct a particular area or if a prosthetic or implant is more appropriate.
The surgical team will always take great care in ensuring that the person is comfortable during any facial reconstruction procedure by using anesthesia. For more involved procedures, the team may recommend general anesthesia, which causes a deep sleep during the surgery.
People undergoing minor surgeries may receive a combination of sedative medications and local anesthesia to put them in a relaxed state with numbness around the surgical area. The surgeon will discuss the most appropriate method before the procedure.
Recovery from Facial Reconstruction Surgery
Recovering from facial reconstruction surgery is a highly variable experience. The length of time involved in healing depends on the underlying damage to the face, the age and general health of the person, their attitude and pain tolerance, and the techniques used by the surgeon.
Facial plastic surgeons always seek to minimize the appearance of scars, working to hide incisions in the natural folds of the anatomy wherever possible. Most visible scars will eventually heal and appear as thin lines that may be paler or darker than surrounding skin.
Before surgery, it is essential that the person discuss the expected course of recovery with the doctor. Issues such as bandages, drains, dressings, care for the surgical site(s), activities, bathing, swimming, diet, sleeping and medications may be part of the doctor’s instructions for the patient.
It is extremely important to follow the surgeon’s postsurgery instructions carefully, especially:
- Avoiding certain activities and environments
- Alerting your surgery team immediately in the event of any problem or unexpected change, especially severe pain in the surgical area
- Keeping follow-up appointments
A New Approach to Craniofacial Bone Surgery
Biomedical Engineer Warren Grayson and other engineers are working on a new approach to craniofacial bone surgery using 3-D printing, cell signaling techniques, and a patient’s own stem cells to create living, anatomically precise facial bones. The goal is to provide patients with a ready-to-implant plastic bone that will gradually dissolve as living tissue forms.