Reconstructive Plastic Surgery
Facial plastic surgeons repair or reconstruct facial features that were a result of birth defects, accidents, assaults, infections or illness. In addition, surgeons can repair fractures, facial nerve paralysis, lacerations, vascular birthmarks, craniofacial deformities and tissue damaged by head or neck cancers or tumor removals.
Facial reconstructive surgery is often done in stages to allow for healing. In children, for example, some surgeries may be done over years to allow for growth and ongoing evaluations.
Many surgical techniques are used in reconstructive surgery. The creation of flaps, sections of living tissue carrying their own blood supply, may be a part of surgery to replace tissue lost to cancer. In other cases where a birth defect has affected the skeletal structure of the face, surgery must focus on building up an area or feature by means of implant or synthetic materials. A bone graft may be taken from the skull and used to recreate facial bones fractured in an accident. Metal rods, plates, wires, and tiny screws may be used to repair a fracture or to secure bone taken from a hip or leg into a new place.
Cleft Lip and Palate
Cleft lip and palate are separate birth defects that may occur together. An infant born with a cleft lip has a fissure or elongated opening where the upper lip failed to fuse. This can vary from a small notch at the top of the lip to a complete separation extending to the nose. If the palate is also cleft, the roof of the baby’s mouth has failed to close.
The goal of surgery is either to close the separation in the child’s lip or the opening in the roof of the mouth, allowing proper speech and eating while improving physical appearance. A baby with a cleft lip typically has surgery to close the lip when he or she is 2 or 3 months old. Depending on the position and extent of the cleft, surgical repair of a cleft palate is usually performed within the first 12 months. Apart from difficulties with eating, the major concerns for children with cleft palate are speech development and dental difficulties. Facial plastic surgeons may be specifically trained to treat congenital deformities such as cleft lip and palate. In addition, they have all been trained to care for airway, swallowing, and ear disorders that are often associated with cleft lip and palate.
Parents receive instructions about helping their child to eat and speak, monitoring their healing and ensuring a healthy recovery. Additional procedures are often required as the child grows, including braces, rhinoplasty and occasionally, other surgery.
Some people are not able to eat and chew their food normally because their jaw is not in proper alignment. Orthognathic surgery can correct this. Besides the functional changes jaw surgery can achieve, frequently there are changes to the way you look as well.
What to expect During orthognathic surgery, a surgeon makes cuts (osteotomies) in the upper jaw, lower jaw or both jaws. The goal of surgery is better movement of the facial bones and teeth into a more appropriate and functional position. This allows you to be able to eat and chew food in a normal fashion.
Jaw surgery is sometimes done at the same time as other elective procedures. Talk to your facial plastic surgeon about what may be best for you.
People who have jaw surgery need to eat a diet of pureed or liquefied food for 7 to 10 days, and then soft foods for example, (scrambled eggs, mashed potatoes, gelatin, soft fish, soups) for about 6 weeks. They usually can resume their regular diet at that time. Most people have elastic bands in place after their surgery that allows some opening. Dietitians are available to help with the diet restrictions and ensure appropriate calorie intake during recovery
Risks may include:
Numbness for up to about 3 months.
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Articles related to Reconstructive Plastic Surgery by Dr. Friedman M.D.
In the Press
NBCPhiladelphia.com - Denise Nakano and Dr. Oren Friedman, Director of Facial Plastic Surgery at Penn Medicine explains why more men are turning back the clock with cosmetic surgery.
CBS News - Stephanie Stahl and Dr. Oren Friedman, Director of Facial Plastic Surgery at Penn Medicine - New Wave of Rhinoplasty
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