Head and face reconstruction

Definition

Head and face reconstruction is surgery to repair or reshape deformities of the head and face (craniofacial).

See also:

• Cleft lip and palate repair
• Craniosynostosis repair

Alternative Names

Craniofacial reconstruction; Orbital-craniofacial surgery

Description

Surgery for head and face deformities (craniofacial reconstruction) depends on the type and severity of deformity, and the condition of the patient.

In some cases, because surgical repairs involve the skull (cranium), brain, nerves, eyes, facial bones, and facial skin, a plastic surgeon (for skin and face) and a neurosurgeon (brain and nerves) work together. Head and neck surgeons may also perform craniofacial reconstruction operations.

The surgery is done while the patient is deep asleep and pain-free (under general anesthesia), and may take from 4 to more than 12 hours to complete. Some of the facial bones are cut and repositioned into a more normal facial structure.

Pieces of bone (bone grafts) may be taken from the pelvis, ribs, or skull to fill in the spaces where bones of the face and head have been moved. Small metal screws and plates may be used to hold the bones in place. The jaws may be wired together to hold the new bone positions in place.

If the surgery is expected to cause much swelling of the face, mouth, or neck, the airway can become blocked. If this is anticipated, the patient may have what is called a tracheotomy, in which a small hole is made in the neck, through which a tube (endotracheal tube) is placed in the airway (trachea). This allows the patient to breath despite severe swelling of the face and upper airway that occurs after some operations and may last for weeks.

Risks

Risks for any anesthesia are:

• Problems breathing
• Reactions to medications

Risks for any surgery are:

• Bleeding
• Infection

Additional risks of surgery of the head and face are:

• Nerve (cranial nerve dysfunction) or brain damage
• Need for follow-up surgery, especially in growing children
• Partial or total loss of bone grafts
• Permanent scarring