Michigan Facial Aesthetic Surgeons > Michigan Facial Aesthetic Surgeons – Reconstructive Surgery

Michigan Facial Aesthetic Surgeons – Reconstructive Surgery

Reconstructive facial surgery is performed to correct functional impairments caused by burns; traumatic injuries, such as facial bone fractures; congenital abnormalities; developmental abnormalities; infection and disease; and cancer or tumors. Reconstructive facial surgery is usually performed to improve function, but it may be done to approximate a normal appearance. Michigan Facial Aesthetic Surgeons are fellowship trained and board certified in all areas of reconstructive surgery and have outperformed expectations in the most complex of cases.

  • Scar Revision
  • Dermabrasion
  • Scalp Loss & Defects
  • Microtia
  • Facial Injury
  • Facial Paralysis
  • MOHS Defects

Scar Revision

Whether due to an injury or prior surgery, any wound that penetrates the full layers of the skin will result in a scar. Depending on the size, location and manner by which it was acquired, a scar may be considered a minor blemish or a major cosmetic and functional problem. If a scar is located near vulnerable locations, such as the corner of the eyelids, corner of the mouth or near the nostril margin, the consequence may be magnified if it distorts these tissues as it will impair their normal function. We have hundreds of hours of experience in cosmetic and reconstructive surgery to ensure you are in good hands..

MFAS surgeons revise scars that distort the above mentioned structures, are too long, wide, depressed, raised, overgrown or travel against the natural skin crease lines of the face. There are many effective methods to correct the problem. Dermabrasion may be used to camouflage the scar by gently sanding down the surrounding area of normal skin and lowering to the level of the scar. The scar may also be excised and the wound re-closed using meticulous plastic surgical technique. Strategies exist to change the direction of the scar so it will run in the same direction as the natural skin creases making it much less apparent. Finally, if a scar is very long and running against the natural skin creases the scar may be excised and a geometric pattern designed to break up its outline. This is known as the geometric broken line closure.

You can feel confident in us as our backgrounds in head and neck and facial plastic surgery provided us the experience and skill to optimize the revision of the scar. We make a concerted effort to educate the patient in postoperative care to maximize the cosmetic result. In addition, MFAS provides the emotional and psychological support to get the patient through a traumatic event.

Listen to an audio description of the scar revision procedure.


Some facelift procedures will not serve to remove the fine-crepe-paper-like-wrinkles of sun exposed skin, or the transverse creases of the forehead and the vertical wrinkles of the upper and lower lips. These effects of aging and sun exposure are best eliminated by the chemical peel or dermabrasion. These two solutions to aging skin remove the outermost layers of the skin to promote a more smooth, uniform and wrinkle free skin. The peel has also been used to remove precancerous lesions in and around the face. Dermabrasion achieves the same result by gently sanding the outer layers of the skin allowing it to regenerate without the fine lines and wrinkles.

After the face is washed and degreased, a peeling solution is applied to the skin with cotton swabs. Once the peel is complete, the face is washed daily and ointment applied until healing is complete. The skin is reddened as though it had been sunburned and is wrinkle free but the redness resolves.

Make up can be applied after 10 days and a mild bleaching agent may be used 6 weeks after the procedure. The pink color of new skin usually remains for 6-8 weeks. Strict avoidance of prolonged sun exposure is advocated for 3-4 months. Adhering to such recommendations ensures a very lasting benefit measured in years.

All peels can be done on an outpatient basis. The deepest peels require close observation and hydration and must be done in an accredited facility. The light and medium depth peels can be done under local and in the office.

Scalp Loss & Defects

The scalp is a unique anatomic structure in many ways. Not only does the scalp protect the skull and underlying cranial vault from the outside world it also contributes significantly to your appearance and character. Through trauma or oncologic removal of a tumor, loss of the scalp and hair can be a source of tremendous psychological and physical distress for the patient. It is our goal to minimize your stress and reconstruct your life as you knew it..

Fortunately, the scalp has a tremendous blood supply that contributes to its ability to heal well and allows for robust reconstruction of most defects. Because the layers of the scalp are not very elastic however, the tissues do not stretch like in other areas of the face and neck. As a consequence, even smaller sized defects that would normally close easily on the face may be more difficult in the scalp.


MFAS surgeons circumvent this situation by designing various flaps borrowed from other unaffected areas of the scalp or employ tissue expanders to gradually expand the scalp so it may then be rotated or stretched into place. Being dually trained in head and neck surgery and facial plastic and reconstructive surgery our MFAS surgeons are experts at even the most difficult reconstructions of the scalp.

Listen to an audio description of the scalp loss and defects procedure.


Any unfavorable situation involving the birth of a child is extremely stressful for the parents and family of that child. Although not life threatening, congenital absence of the external ear has major physical and social implications for that child. Not only aesthetically compromising, the ability to hear is also at risk due to absence of the ear canal or malformation of the hearing bones themselves.
MFAS surgeons use classic, time-honored techniques to reconstruct the external portion of the ear. We use native tissue harvested with a small incision over the rib cartilage. Cartilage is then harvested, sculpted and contoured into the framework necessary for an external ear. This is placed into a precisely designed pocket adjacent to the remnant of the ear. The skin of this pocket will then provide the skin to cover the sculpted external ear. This is the most robust portion of the reconstruction. Over the ensuing months, there are two or three other stages that are less involved but are quite important for the overall result. After the final operation, a new external ear is created to replace the absent ear. Then, our dedicated ear surgeons undertake the restoration of the hearing mechanisms to restore the hearing to as close to normal as possible.

We understand that congenital malformations of the external ear bring great distress to the family of the child. Every step of the way we will guide and support both the child and the family until the final reconstruction is obtained. MFAS is wholeheartedly dedicated to the physical and emotional well being of the patient and the family.

Listen to an audio description of the microtia procedure.

Facial Injury

Whether a consequence of accident or assault, injuries to the face and facial skeleton are still common in today. Usually patients are initially evaluated in the emergency room setting and our services are requested at that time. Depending on the nature and seriousness of the injury, surgical correction is performed while the patient remains in the hospital or as an outpatient after facial swelling has subsided. Our surgeons pride themselves as being considered leaders in the treatment of craniomaxillofacial injuries. MFAS surgeons have attended to hundreds of severe facial injuries over the years and average 3 to 4 surgeries a week.

The knowledge, experience and surgical acumen of our surgeons is reinforced by our invitation to speak at local, regional and national meetings in addition to providing hands-on instructional courses in the treatment of these injuries. Many times, patients are referred to us from Michigan and the Great Lakes region for facial injury care.

Our surgeons have tremendous experience in dealing with soft tissue injury of the face including lacerations, abrasions, loss of tissue, damage to salivary glands, facial musculature and nerve injury. In addition, correction of post-traumatic deformity such as unsightly scars, sunken cheeks, malpositioned eyes and eyelids and missing external ear are commonly treated.

We realize with any traumatic event the immediate injury and emotional distress prevails. There may be, however, a period of post injury deformity, depression, anxiety or worry that plagues the patient. Our surgeons will provide the supportive care necessary to optimize healing, maintain normal function of the face and facial skeleton, re-establish proper aesthetics and guide the patient through post injury stress. We pride ourselves on being internationally recognized leaders in the treatment of craniomaxillofacial injury and will do all that we can to rehabilitate the patient to their pre-injury state.

Listen to an audio description of the facial injury procedure.

Facial Paralysis

Perhaps no other problem encountered by the facial plastic and reconstructive surgeon is as devastating both cosmetically, and functionally than paralysis of the facial musculature. The facial nerve courses from the brainstem, through the skull base and into the cheeks. There are five main trunks of the nerve that control the upper, middle and lower portions of the face. The facial nerve may be destroyed as a consequence of trauma or from removal of a cancerous tumor.

The facial nerve which controls these muscles is critical for a number of functions many of us do not even realize. This includes expression and animation of the face, closure of the eyelids and protection of the eye, pursing of the lips and providing oral tone that is necessary for speech and eating. If one or all the muscles of the face are paralyzed the consequences are quite severe.

Slight weakness may not be detected by the casual observer, however, more severe cases can have intense psychological and functional consequences for the patient. The inability to properly close the eye and its constant tearing and irritation can be a potential threat to one’s sight. Paralyzed facial muscles will make annunciation and speaking more cumbersome. Flaccid and weak lips and mouth will make eating much more difficult as foodstuffs and liquids will tend to leak from the corner of the mouth. Controlling one’s secretions will also me much more challenging. These are all things many of us take for granted.


Our unique training in head and neck surgery and facial plastic surgery has given us the tools in making a proper diagnosis, eliciting an appropriate prognosis and providing the maximal therapeutic regimen.

Treatment may entail nerve grafting and reconstitution of the integrity of the nerve to repositioning of the brow and forehead complex in addition to repositioning of the lower eyelid. We also strive to reposition the middle and lower thirds of the face with complex nerve grafting, muscle repositioning and facelifting.

We approach facial nerve paralysis with the utmost of seriousness and will do everything to correct the situation. We employ a multidisciplinary team to maximize the outcomes while providing continuous support for the patient.

Listen to an audio description of the facial paralysis procedure.

MOHS Defects

Despite greater patient education about the damaging effects of the sun, skin cancer is unfortunately still a great issue. As the population ages so does our cumulative time in the sun predisposing to basal cell cancer, squamous cell cancer and melanoma. When present on the face, usually in a cosmetically sensitive area, our dermatology colleagues perform a highly effective excision of the tumor using the MOHS technique. Although MOHS is the best technique to conserve tissue and excise only the tumor with a safe margin, it often times results in a loss of tissue that needs to be replaced. This is when our expertise is required.

Using neighboring tissue from the nose, cheeks and forehead the defect can then be patched. We take great care and great pride in meticulous wound closure. We do everything to preserve the normal anatomic function and the aesthetics of the area that was previously excised. Once the healing process is complete, most observers would have to closely scrutinize the area to realize that you have had any type of reconstructive surgery.

We provide the utmost guidance and support in the post-operative period to maximize wound healing and the overall outcome. It is not uncommon to perform an initial operation to restore the bulk of the wound and ensure proper coverage of the defect followed one or two smaller operations for the final touchup.

MFAS surgeons draw upon considerable experience and training in head and neck surgery, oncologic reconstruction and aesthetic ideals to provide the best result.

Listen to an audio description of the MOHS defect procedure.

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