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Reconstructive Surgery

Congenital Deformities (e.g. cleft lip and palate)

A cleft lip and palate is the most common birth defect of the face that involves a split in the upper lip and/or gap in the roof of the mouth.  Over 6,000 infants are born in the US each year with this condition, which is caused by abnormal development of the lip and palate.  A cleft lip and palate can cause feeding, speech, ear and dental problems.

A cleft can appear in the lip or palate alone, or in both areas and on one or both sides of the mouth.  Children with clefts are at higher risk for ear infections and dental problems.  Feeding is usually difficult as well. 

Reconstructive surgery is the recommended treatment for clefts.  This surgery is usually performed when the child is 3 to 6 months for a cleft lip and 9 to 14 months for a cleft palate. It is recommended for your child to regularly meet with different specialists in order to help develop the areas that may be affected by the clefts.  Although this condition requires a lot of care, it is manageable and can be overcome by many children with the help of a trusted team of doctors.

Eyelid Surgery (e.g. eyelid ptosis, or "droopy" eyelids)

Ptosis (droopiness) is a common condition that can affect the upper eyelid of one or both eyes as a result of aging, a congenital defect, muscle deformity or neurological disorder.  This condition can occur in patients of all ages, but is most common in older patients and will likely continue to worsen with age. 

In addition to drooping of the eyelids, patients with ptosis may also experience:

  • Difficulty closing the eye or blinking
  • Tearing
  • Eye fatigue
  • Double vision

Patients may seek treatment for droopy eyelids for cosmetic and/or medical purposes.  Severe drooping may obstruct vision as the eyelid gradually droops lower and lower, eventually covering the eye.  Other patients are simply bothered by the appearance of their eyelids.  Treatment for this condition usually involves eyelid surgery, known as blepharoplasty.  This procedure involves lifting the eyelid and reattaching it to a higher location on the face. 

Facial Fractures in Children and Adults

An injury to the face of head, as a result of a motor vehicle accident, fall, sports-related injury or other cause, may affect a patient’s sight or their ability to breathe, speak or swallow. A facial fracture involves a break or crack with any combination of the bones in the lower or upper jaw, palate, cheekbones or eye socket.

Treatment of facial fractures is similar to the treatment of a broken arm or leg. The method of treatment is determined by various factors, such as the location and severity of the fracture, as well as the age and health of the patient. If surgery is needed, incisions are usually small and placed in areas such as the hairline or jaw so that the resulting scar is hidden from view.

Facial Paralysis

Facial paralysis involves a loss of voluntary muscle movement within the face, which may occur as a result of stroke, brain tumor, infection, trauma, Bell’s palsy or other factors. The facial nerve stretches down each side of the face and allows us to laugh, cry, smile or frown when functioning properly. Patients with facial paralysis may experience symptoms such as:

  • Drooping of the face
  • Difficulty making facial expressions
  • Twitching
  • Headache
  • Loss of taste

Treatment for facial paralysis depends on the underlying cause of the condition, but may include medication, physical therapy or surgery to relieve pressure on the facial nerve or to repair a severely damaged facial nerve. It is important to maintain the health of the eye when the facial nerve is paralyzed. This can be done by wearing protective glasses or patches and using drops to keep the eye moisturized.

Scar Revisions

Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. Scars are by definition permanent, but surgery can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands.

There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, flap surgery and Z-plasty (repositioning a scar so that it aligns with the face and is less noticeable). The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, your body’s healing mechanism, the size and depth of the wound, how much blood supplies the area and the thickness and color of your skin. 

Skin Cancer (Mohs) Defect Repair

Mohs Micrographic Surgery is intended to remove cancers while preserving as much healthy tissue as possible and leaving only a small wound. Unfortunately, even this highly precise technique can result in a large wound or a scar, which can be especially upsetting if the tumor was on a cosmetically critical area of the body such as the face or hand. Having a plastic surgeon close the initial wound ensures that post-operative scarring will be kept to a minimum and may even be unnoticeable. Patients who have had Mohs surgery in the past can also come to a plastic surgeon for scar revision.