Facial Bone Surgery
Who Performs It?
Surgery to alter the facial bones is best performed by Board Certified plastic surgeons who have been additionally trained in Craniofacial surgery in a Fellowship. Dr. McKinnon is Fellowship trained in pediatric and adult maxillo-facial and craniofacial surgery by recognized world experts and has been performing and teaching this type of surgery for 40 years.
His relevant organizations in this surgery are the American Society of Plastic Surgeons, the American Society of Maxillofacial Surgeons, the International Society of Craniofacial Surgeons and the American Association of Plastic Surgeons.
What Is It?
Craniofacial and maxillofacial surgery can correct facial fractures, loss of bone from tumors, facial undergrowth, facial overgrowth and facial asymmetry. Bones that are too small can be expanded by cutting and moving them into a new position. Adding bone to increase facial volume is also done by bone grafting which is preferable to implants of plastic or other man-made substances, especially in children. Bone grafts are harvested from different areas of the body such as rib, hip or skull. They are permanent, rarely involve infection or dislodgment, and do not create unwanted reaction to a patient’s own tissue. Yes, bone grafts require additional surgery but to the vast majority of patients the result is worth the effort. Donor bone graft sites are rarely a problem for the patient treated by an experienced surgeon. Dr. McKinnon has performed hundreds of bone grafts from the skull, hip and ribs, and without a surgical infection.
Reduction of facial bones is often done for patients with relative overgrowth of bone such as the forehead, cheeks or mandible and chin. Reduction of bone is also sought by patients seeking a softer or more feminine appearance. Facial bone reduction can sometimes be performed by removing superficial bone surface with electronic drilling. More severe reductions may require an osteotomy (cutting the bone) and reattachment of the cut bone to the underlying structure with metallic plate and screws or steel wire. Often the incisions can be hidden under the scalp or inside the mouth. Reduction of facial bones entails the possibility of changing the facial soft tissue, and attention to this soft tissue is also best undertaken by a craniofacial trained plastic surgeon.
Who Are Candidates?
Patients with history of trauma, tumors or developmental asymmetry of the facial bones are frequent candidates for craniomaxillofacial reconstruction. A thorough in-office examination of the patient is always required and radiographic examination with computerized scan or plain X-Rays is usual prior to most surgery. Patients who are unhappy with their facial features are frequent candidates for bone reconstruction and/or reshaping. Patients with poor occlusion of their teeth (malocclusion) are frequent candidates for bone reconstruction. Many patients who have undergone prior orthodontic treatment may still exhibit asymmetry or imperfections of occlusion which may deserve facial bone surgery for final correction. Examples of Dr. McKinnon’s patients who have undergone facial bone reconstruction may be viewed in the website Gallery under Facial Reconstruction, Facial Trauma, Genioplasty, Nasal Reconstruction, Encephalocele, Clefts and Neurofibromatosis. Patients with tumors such as Neurofibromatosis frequently experience destruction of facial bones and require both tumor resection and reconstruction of bone(s), often in one operation.
