What is Facial Reconstruction Surgery?
Facial reconstruction surgery is used when a patient has lost skin, bone continuity has been disrupted, or scarring has interrupted the normal skin texture, color, or elasticity. Surgical restoration of the face requires expert handling of the skin and accurate reduction and fixation of the underlying bone and skeleton.
Why see Dr. Jose Barrera, MD, for facial reconstruction?
Dr. José Barrera, MD, has honed his skills in facial reconstruction through his residency at the University of Colorado Department of Otolaryngology-Head and Neck Surgery and fellowships at Stanford University focusing on Maxillofacial and Sleep Surgery and Facial Plastic and Reconstructive Surgery. He has served 25 years in the U.S. Air Force having achieved the position of Chairman of Otolaryngology-Head and Neck Surgery at SAMMC and the Chief of Surgery and Anesthesia while deployed. He is the co-editor of the Borden Trauma Book on Head and Neck Trauma Surgery and has published numerous articles on facial reconstruction and head and neck trauma.
What does the preoperative consultation entail?
Most patients presenting for facial reconstruction have undergone micrographic (Mohs) surgery for a skin malignancy. Dr. Barrera works closely with your referring dermatologist and coordinates care ensuring tumor clearance and post ablation reconstruction of the facial defect. The consultation provides an opportunity to address your goals, discuss the anticipated surgery, the number of stages required for repair, and all reconstructive options. Other patients have resultant trauma with discontinuity of the underlying boney skeleton leading to facial deformity, asymmetry, and malocclusion. Factors associated with reconstruction involve the mechanism of injury, timing of repair, and associated dental and skeletal involvement. Imaging and dental modeling may be necessary to fully appreciate the injury and planning for repair. Other patients present with facial scarring from acne, industrial injury, burns, or traumatic skin loss. In patients with facial scars, dermabrasion, laser therapy, and surgical repair may be options to use for repair.
How are facial wounds managed?
Wound care involves replacing skin with similar color and texture. The average number of necessary surgical procedures and length of time to complete all stages of reconstruction are discussed. Nose defects may require an interpolated flap from the forehead or adjacent cheek. Aesthetic units of the face are adhered to in reconstruction in order to maintain, reform, or replace facial landmarks including the eyebrows, melolabial creases (laugh lines), mental (chin) crease, philtral crests in the nose, vermilion borders of the lips, and the hairline. These aesthetic regions and their borders form the character and uniqueness of the individual face.
What type of repairs are possible?
Patients presenting with congenital abnormalities such as cleft lip and palate deformity, traumatic injury from motor vehicle accidents or sports injuires like nasal fractures, skin and muscle loss from cancer resection, or loss of aesthetic units of the nose, eyelid, ear, lips, scalp, face, or neck can be repaired using local and regional flaps, and in some cases free flap reconstruction.