A multidisciplinary team approach is used to evaluate and treat the underlying problem using CT, MRI and virtual surgical planning to determine the optimal treatment plan. The surgical team includes physicians with training in oral maxillofacial surgery, microvascular surgery, cosmetic surgery, maxillofacial prosthodontics, anaplastology, and general dentistry. Maxillofacial prosthodontics specialists are available for facial and oral prosthetic rehabilitation, including replacement of missing teeth using dental implants. Our anaplastologist can create any structure within the face including prosthetic noses, ears, and eyes. Further information regarding maxillofacial prosthetics and anaplastology can be seen in the Center for Maxillofacial Prosthodontics (create link here).
Microvascular surgery is a technically demanding procedure during which tissue grafts harvested (taken) from the arms, legs, abdomen, or back are transferred to the mouth, throat, or face to replace missing tissues.
Candidates for this type of surgery include patients who require surgery for oral/head and neck cancer, or suffer from the effects of radiation therapy given to treat head and neck cancer, as well as patients with severe traumatic injuries of the face or neck. Areas commonly reconstructed include the jaws and mouth, the throat, and all areas of the face, scalp, and neck.
A successful outcome in this type of reconstructive surgery depends upon meticulous suturing of one to three milimeter blood vessels using a microscope and sutures that are finer than human hair to reestablish blood flow to the tissue graft. For patients undergoing surgery to remove a cancer, use of this technique allows for immediate reconstruction of the bone or soft tissue defect and generally ensures that the patient undergoes only one surgical procedure. (Link to Virtual Surgical Planning)
We are experienced in reconstructing nasal injuries or deformities and functional breathing problems arising as a result of a broken nose, previous nasal surgery, treatment of nasal skin cancer, and congenital problems, including the nasal deformity commonly associated with cleft lips.
Patients who have suffered a recent broken nose are advised to be evaluated between five and 10 days after the injury has occurred, as they may be candidates to undergo reduction of a displaced nasal bone fracture in the office setting, potentially avoiding the need for surgery. Patients with longstanding nasal fractures resulting in a nasal deformity or nasal breathing difficulty may be considered for reconstruction of their problem by means of septorhinoplasty. Patients with an unsatisfactory result after previous nasal surgery may be considered to be candidates for revision surgery by our surgical team.
Surgical team members are highly skilled and experienced in treating patients who have suffered fractures involving the jaw bones, the cheek bones, the orbital bones, and the skull. Surgery can often be accomplished using incisions which are well hidden by placement inside the mouth, in hair bearing scalp skin, and on the inside of the eyelids, often avoiding visible facial scars. Patients with recent fractures or problems that persist after remote facial fractures are often considered to be candidates for reconstruction.
This is a procedure performed by a dermatologist fellowship trained in Mohs Surgery and is a procedure to remove skin cancer to give the best cure rates. Sometimes these defects after removal of skin cancer are large and require sedation or general anesthesia for reconstruction. We have extensive experience in comfortable anesthesia and closure of these large defects.