What is facial reconstruction?
Facial reconstruction encompasses the set of surgical techniques aimed at recovering the appearance and functions of the face lost after an accident or the removal of a head and neck tumor. It requires the mastery of multiple reconstructive procedures, from the simplest ones such as a skin graft to the famous face transplants involving different specialists.
Each face is unique and is characterized by a particular bone and dental structure and a soft tissue coverage (skin, muscles and fat) that varies with age. The face partly determines our character and is the main organ of expression of our emotions. Thus, Oral and Maxillofacial Surgery is the only medical specialty that specifically treats problems of the mouth and face, taking into account their aesthetic importance and the localized functions in the area such as chewing, speech, mimicry, vision, smell and hearing.
Which patients benefit from these techniques?
On the one hand, there are patients affected by skin cancer of the face, which is becoming more and more frequent and requires the removal and reconstruction of the skin by means of techniques that use the redundant areas close to the defect. In medical jargon they are called “local flaps”. The procedure is performed under local anesthesia and the main reconstructive objective is to leave an imperceptible scar.
On the other hand, there are patients who need reconstruction after having undergone surgery or radiotherapy for cancer of the tongue, mouth or jaws. They require the use of more complex techniques that mobilize tissues (skin, muscle or bone) from regions close to the face or from more distant areas such as the abdomen, extremities or the patient’s back. We use regional flaps that use skin and muscle that maintain their blood flow from arteries and veins close to the head and microsurgical flaps that use skin, muscle or bone from more distant areas and require meticulous suturing of the artery and vein that nourish them in blood vessels in the neck. Apart from preserving the patient’s previous appearance, the main reconstructive goal is to maintain the functionality, speech, swallowing, chewing and mobility of the face.
Finally, in private practice, the third reconstructive challenge one faces is the sequelae of facial trauma. In particular the sequelae of fractures of the orbit of the eye and nose. These problems leave very important limitations such as double vision or difficulty in breathing. The loss of facial symmetry is a major stigma for the patient,
What are the risks involved in this operation?
As in any surgical procedure there are risks inherent to anesthesia, risks specific to each technique and disease and risks associated with the patient’s medical history. Complications are directly related to the severity of the procedure, time of intervention, state of health, age of the patient and experience of the surgeon. In addition, bleeding, infection and total or partial loss of the flap may occur. It is important to know that all of them have a solution.
What kind of care should the patient have after the operation?
Depending on the severity of the process and the reconstructive technique used, patients can be operated on an outpatient basis, without admission, with removal of stitches within a week in the office or require hospitalization for more than 10 days.
What are the results?
Excellent, but for this it is vital to use the appropriate technique for each patient and disease, extensive experience in treating this type of cases, the use of 3D planning technology and appropriate follow-up. Good communication with the patient and his or her family is essential for them to understand the objectives of the treatment, the expected results and the complexity of the reconstructive process, which sometimes requires several interventions.