What is facial reconstruction?
Facial reconstruction is a surgical revival of the face, which is done to improve facial functioning and the appearance of patients who suffer from head or facial deformities. These deformities can occur due to any cancerous diseases, paralytic attacks, trauma injuries or defects that come with birth.
What is done in a facial reconstruction surgery?
In most cases of facial reconstruction, especially those caused due to trauma, the surgeons will transplant soft tissue and bone from other areas of the body to bring a balanced facial appearance. In some cases, the need might differ and the surgeons might have to use synthetic implants especially for the jawline, chin and cheeks.
What is the outcome of a facial reconstruction surgery?
The best outcome and successful results of the surgery depends on the patient following the doctor’s instructions before and after the surgery. Postoperative care plays a major role in speeding the patient’s recovery. Patients must also understand the possible risks and complications of a facial reconstruction surgery, and make sure they have realistic expectations for the outcome.
Benefits of a facial reconstruction surgery
Facial reconstruction surgery can improve or hide most imperfections, including severe ones like facial trauma injuries. Regardless of the reconstructive treatments undergone, the final results usually vary because the underlying problem is unique in every patient. During your consultation, your surgeon will discuss your options and outline realistic expectations and goals of the treatment that will be recommended.
Who is an ideal candidate for a facial reconstruction?
Ideal candidates for a facial reconstruction surgery should have good health and reasonable expectations from the surgery. Satisfactory results are most seen in all ages including young children and adults as well.
Most widely chosen areas of the face for reconstructive procedures are:
Lip: The study of lip defects are diverse, including cancer deformity correction, trauma injury correction, burns etc. In a lip reconstruction, usually the soft tissue from the cheeks is taken and transplanted. The lip is completely grafted and reconstructed with silicon implants in some cases that need a bit more sculpting than usual.
Cheek: The cheeks represent the largest surface area of the face and are responsible in framing the central facial units. This anatomic arrangement exposes the skin of the cheek to trauma, and to the effects of the sun exposure. This in turn leads to the frequent need for a reconstructive surgery.
Analysis of the defect is a critical part of any reconstructive procedure. The defects can be simple including skin and subcutaneous tissues or can be complicated including muscles, facial nerves and bone.
Here are a few reconstructive procedures that are commonly done to revive the cheeks:
1. Primary Closure: A reconstructive method of choice if excess tension distortion of surrounding tissues can be avoided. This technique results in the simplest scar that fades with time, and donor site scarring as well.
2. Skin Grafts: Skin grafts are occasionally useful for cheek reconstructions. Although skin grafts look like patchy depressed scars, they can be a reasonable option for patients with significant conditions on whom other procedures may be too risky.
3. Local Flaps: Local flaps are formed by relaxing a layer of tissue and then stretching the freed layer to fill the defect or injury on the cheeks. Local flaps are the simplest type of flaps used for cheek reconstruction procedures. Local flaps include three subtypes of flaps that are used for cheek reconstruction. These are in order from least to the most complex local skin flaps.
- Advancement flaps
- Rotation flaps, and
- Transposition flaps
4. Tissue Expansion: The tissue expansion technique is used in cheek reconstruction to resurface wider defects/injuries with the skin that is similar in texture and skin tone (colour) along with being superior to the skin on any other part of the body, exceeding other conventional methods.
5. Microsurgical Reconstruction: Microsurgical reconstruction is another important option for complex defects that involve multiple tissue layers. These techniques are useful for resurfacing massive skin grafting and mostly for patients in whom local flaps may be difficult to extract. (E.g. Facial burns, contaminated wounds like a gangrene and people who’ve undergone radiation therapy)
Nose: Nasal reconstruction involves treatment of noses that lose the nasal tissue either due to any trauma injuries or because of cancer excision. A nose reconstruction is very different from a revision rhinoplasty, which is usually a cosmetic procedure. Nasal reconstruction and revision rhinoplasty involve different surgeries including different techniques and mindsets.
How long does it take to recover from the above mentioned procedures?
The nature of every reconstructive treatment can be differentiated based on the degree of the complexity. In cases of minor trauma or defects the procedures may not take much time to heal. However, if the injury or facial deformity is on the severe side, it may take at least a minimum of 3-6 weeks to recover post the surgery. The pace of recovery also depends on the patient’s healing ability and if the patient follows the instructions of the doctor properly and regularly.