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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.
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.
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.
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.
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.
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.
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.
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.