Craniofacial Surgery

Craniofacial surgery is a specialized branch of plastic surgery that deals with correcting problems occurring in the face or skull. Various surgical interventions can be employed to correct congenital or acquired abnormalities in the jaw and skull regions. Plastic surgeons specialized in craniofacial reconstruction collaborate with orthodontic specialists to create an effective treatment plan.

Craniofacial deformity correction reshaping the facial and skull bones with the aim of restoring a normal appearance and enhancing functions in the affected area.

The diagnosis of the condition is typically made through a clinical examination involving a review of family and medical history, cephalograms, CT scans, MRI, and three-dimensional imaging processes. A patient archive is prepared with photographs taken from various angles, and based on evaluations, a craniofacial surgical plan is formulated.

Addressing issues in the face or skull requires a collaborative effort in craniofacial anomalies surgery. Surgeries are performed by a team consisting of highly trained surgeons and medical specialists. This team typically includes a plastic surgeon, a neurosurgeon, an orthodontist, an ophthalmologist, an ear, nose, and throat specialist, a radiologist, a medical geneticist, an anesthetist, a medical photographer, and an artist.

Craniofacial surgical procedures involve crucial details that contribute to the success of the process. Depending on the patient’s needs and treatment situation, specific techniques are utilized during the procedure. The steps to be followed during the surgery are as follows:

1. Planning is conducted before the surgery. The patient undergoes comprehensive assessments, including CT scans and MRI imaging, to evaluate the extent of the deformity.
2. The patient receives general anesthesia during the surgery.
3. Incisions are made in the face, scalp, or mouth, depending on the treated area.
4. Bone is reshaped to correct the deformity.
5. Soft tissues such as muscles, skin, and cartilage may be reconstructed to restore the function and normal appearance of the affected area.
6. Various techniques, including stitches, are employed to close incisions.
7. After the surgery, the patient is closely monitored for a period to manage any potential pain or complications.

The aim of craniofacial surgery is to treat conditions affecting the skull, face, and jaws, helping to improve the appearance and function of the affected area. Defects treated in craniofacial surgery include:

• Craniosynostosis is a condition where the skull abnormally grows due to the premature closure of sutures between the bones. Craniofacial bone surgery reshapes the skull to correct this condition and allow for normal brain growth.
• In the treatment of cleft lip and palate, a congenital defect, the gap is closed to enhance the appearance of the area and strengthen functions.
• Facial traumas, including fractures and tears, are addressed in the repair of injuries. Craniofacial trauma surgery is applied to rectify skin and bone losses in the skull resulting from incidents like traffic accidents and gunshot wounds.
• Craniofacial tumor surgery aims to repair deformities resulting from the removal of tumors in the skull and facial region. Tissue transplants using craniofacial microsurgery methods can be performed after the extraction of tumors.
• In cases where the bones in the skull and facial region do not develop adequately, a device is implanted. This surgical method, applying the principle of distraction osteogenesis, involves the extension and growth of bone tissue.
• Facial skeleton surgery is intended to achieve aesthetic symmetry in hemifacial atrophy (Romberg’s disease).
• Pediatric craniofacial surgery encompasses interventions in the skull and facial region in children. The treatment is carried out considering the child’s growth potential.

Deviation occurring during the formation and development stages of the head, neck, and facial regions can lead to craniofacial anomaly disorders. Besides genetic factors, environmental influences also play a role in the emergence of anomalies. Substance dependencies, medications, and radiation are among the leading factors.

This disorder is classified based on anatomical locations, etiology, morphological, or clinical genetic characteristics. There is considerable confusion in classifying syndromes containing craniofacial anomalies. This is because different mutations in a single gene can lead to different syndromes, or mutations in different genes can cause the same syndrome.

The surgeon employs various procedures, such as craniofacial microsurgery, to correct disorders in the relevant region and restore functionality. The procedures include:

• Repairing skull fractures to preserve brain tissue and ensure functionality.
• Interventions to correct facial nerve damage, enhancing facial expressions and sensory functions.
• Surgical procedures for deformities around the eyes.
• Nose reconstruction methods are utilized for aesthetic and respiratory functional restoration.
• Normalization of jaw functions and correction of oral structure.
• Correction of respiratory functionality by addressing issues in the nose and throat.
• Post-surgical therapy may be applied to improve language and speech functionality.

Craniofacial surgery not only corrects functional aspects but also provides aesthetic improvements, significantly enhancing patients’ quality of life.

Craniofacial reconstruction involves several fundamental methods, including bone grafts, tissue expansion, free flap transfer, 3D printing technology, endoscopic surgery, and distractions. The method to be applied is determined based on the patient’s needs.

Various applications of craniofacial reconstruction include post-traumatic recovery, correction of congenital anomalies, correction of defects arising after cancer, tissue transplants, and aesthetic purposes. These applications, requiring a multidisciplinary approach, are carried out in collaboration with expert surgeons from different fields.

The postoperative care and recovery process following craniofacial surgery can vary depending on the applied method and the patient’s condition. Postoperative instructions provided by the doctor, such as wound care, medication usage, and activity restrictions, should be closely followed. During the recovery process, it is important to rest and avoid strenuous activities. Patients should pay attention to their nutrition and ensure adequate fluid intake.

In some cases, physical therapy and rehabilitation treatment may be recommended to help the affected area regain functionality. It is crucial for patients to stay in communication with their doctor throughout the recovery process to successfully complete the journey.

The cost of craniofacial surgery can vary depending on the method and procedures used. Factors such as the hospital where the surgery will be performed, insurance coverage, and the use of technology and materials can influence the pricing.

Postoperative care and rehabilitation are determined based on the patient’s health condition and the type of surgery performed. It is crucial to follow the doctor’s recommended instructions during this period. In some cases, physical therapy and rehabilitation may be necessary to support postoperative recovery.