As a board certified plastic surgeon and otolaryngologist (head and neck surgeon) it has always been my philosophy on facial aging that the most natural looking, long term results are achieved by approaching the face as a unified whole rather than a combination of distinct elements. The results from a rhinoplasty procedure to deemphasize an overly prominent nose may be significantly improved with facial contouring to augment a weak jaw line. While it is common to separate plastic surgery procedures into “reconstructive” and “cosmetic” types, the features of the face must all work together to create a harmonious whole and so the distinction between the two is sometimes not so perfectly clear. Many patients who have undergone reconstructive surgery early in life, usually as a means to treat congenital defects, return years later to have other facial features contoured or sculpted to create a more seamless and aesthetically integrated profile.
Cleft lips or cleft palates, together commonly referred to as “orofacial clefts,” occur when a baby’s lip or mouth does not form properly during pregnancy. Because the palate and upper lip form independently, it is possible for a baby to have a cleft lip, a cleft palate, or both. Orofacial clefts are among the most commonly occurring facial birth defects, affecting more than 7,000 infants in the United States each year, and can ultimately cause difficulties in eating, speech, and respiration. While reconstructive facial plastic surgery is commonly used to correct these defects, it is possible for subtle, long term effects to linger into adulthood. Specifically, a cleft lip can affect the nasal septum, the structure within the nose that separates the left and right nostril, causing a deviated septum that can affect breathing and cause congestion problems in patients. Many of these patients seek rhinoplasty, or nose surgery, after the facial features are fully developed to both relieve breathing difficulties and bring the size and shape of the nose into better proportion with the rest of the facial features.
Another defect present at birth, craniosynostosis, or an improper fusing of the plates that make up the developing skull, can also cause aesthetic deficits that can be corrected by cosmetic surgery procedures. The first reconstructive surgeries to separate the fibrous joints between the plates so that they can grow back together correctly are performed in the patient’s first year, but as the features of the face continue to grow and develop, some patients look towards brow lift surgery or other facial contouring procedures to maintain symmetry and a more aesthetically pleasing appearance.
These are just a few of the ways that cosmetic plastic surgery can be used to enhance or improve the effects of facial reconstruction surgery. If you are interested in any of the facial plastic surgery procedures I perform, please contact my office, to schedule a consultation. Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.