“New surgical techniques for tissue regeneration (fat and bone) open new horizons improving the aesthetic and functional outcome and thus the quality of life of affected patients”
Perspectives on improvement of the quality of life in adults suffering from congenital deformities
Hundred years ago autologous fat injections were introduced in Berlin in order to enhance soft tissues for facial contouring in cases of congenital malformation or traumatic loss of tissue. The autologous fat injection was re-discovered again in the 90s, opening new perspectives in soft tissue reconstruction. Techniques for lengthening the facial skeleton (bone lengthening/ distraction osteogenesis) revolutionized craniofacial surgery in the 90s. Through the lengthening of the facial skeleton, the aesthetic and functional outcome changed dramatically.
Anomaly/ Syndrome & Treatment (Common description vs. Medical description)
- Cleft lip and palate
- Treacher Collins
- Binder syndrome
- Crouzon, Pfeiffer, Apert
- Hemifacial microsomia
- Fibrous dysplasia
Cleft lip and palate
· Treatment: Advancement of the upper jaw, scar correction, total lip correction (muscle repair), closure of residual holes in the palate, harmonization of the upper jaw (nose base) with bone grafts as a precondition for nose correction, lip enhancement in depressed areas with fat injections, surgical hair restoration in the scar area; Medical description: Maxillary distraction osteogenesis, scar revision or re-operation of the lip including muscle reconstruction, secondary palate repair, bone grafting in the cleft area including the piriform aperture as a precondition to rhinoplasty, open extracorporal septorhinoplasty, micro fat transfer for lip enhancement, hair transplantation.
Franceschetti Syndrome / Treacher Collins
· Treatment: Fat injection to enhance cheekbone area, cheekbone correction with bone grafts (or bone lengthening), final face modeling using fat graft, nose surgery, ear surgery, chin surgery (forward displacement of the chin), lid correction; Medical description: Lipofilling, bone grafts (or distraction osteogenensis), rhinoplasty, sliding genioplasty (in extreme cases distraction osteogenesis), otoplasty, lateral canthopexy.
Binder syndrome /Binder Phenotype
· Treatment: Nose surgery (nose lengthening as a piece via distraction osteogenensis), classical nose correction for refinements; Medical description: Naso-maxillary-distraction, rhinoplasty.
Crouzon’s disease, Pfeiffer & Apert Syndrome
· Treatment: Upper jaw lengthening (gradual advancement by distraction osteogenesis), lid correction; Medical description: LeFort III osteotomy and distraction, lateral canthopexy.
· Treatment: Cheekbone enhancement using bone grafts and fat; mandible reconstruction using bone grafts and bone lengthening (distraction); ear reconstruction; Medical description: Malar and mandibular reconstruction with autogenous bone graft, distraction osteogenensis, lipofilling for cheek enhancement, otoplasty.
Fibrous dysplasia / Benign bone tumor
· Treatment: Tumor reduction involving the whole facial skeleton. The tumor reduction in the area of the eye socket is performed by using a navigation system; Medical description: Modeling osteotomy of the facial skeleton, navigation of orbit.