What is Craniofacial Reconstruction?

Craniofacial reconstruction refers to surgical procedures, often extended and complex, that are used to change the shape of the skull and the face. This type of surgery is most often used to correct major injury to the face or skull or to correct birth defects that distort the normal structure of the skull or of the face. Often, a cosmetic surgeon and a neurosurgeon must work together for successful craniofacial reconstruction, because numerous nerves exist in the face and skull and must be protected during surgery in order to prevent reduced sensation or motor function in the face. Reconstructive surgery focused primarily on the bones surrounding the eyes is referred to as orbital-craniofacial surgery.

Common applications for craniofacial reconstruction include face repair and skull repair. The need for repair to the face or skull can be the result of accidents in which facial bones are broken, fractured or crushed, such as a car accident or blunt force trauma to the face or skull. Reconstruction also can be used to repair facial bones after cancer surgery that requires sections of bone to be removed. In many cases, craniofacial reconstruction involves a transplant of bone grafts from other parts of the body into the face or skull. Surgeons also use pins, plates and other tools to hold broken bones in place during healing.

Craniofacial reconstructive surgery also is used for cleft lip repair, a birth defect in which the palate, or the bones that form the top arch of the mouth, fail to fuse properly. Cleft palate occurs in one out of every 700 births in the United States, making it the fourth-most common birth defect for infants in the U.S. Other birth defects that can require craniofacial reconstruction include Down syndrome, Treacher Collins syndrome, Crouzon syndrome and Apert syndrome, all of which involve various levels of deformity of the face and skull.

The term craniofacial reconstruction also is used to refer to using the facial and skull bones to reconstruct an image of what a person looked like while they were living. This kind of craniofacial reconstruction is used most often in forensics. A reconstruction made from the skull of a murder victim, for example, can be used to identify the victim. Craniofacial reconstruction as used in forensics has existed since the 1920s. Reconstructing a face from a skull also can be employed by surgeons attempting to recreate features in a patient whose face has been disfigured by injury.