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Soft-Tissue Surgery of the Craniofacial Region

2007 Edition, June 20, 2007

Complete Document

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Active, Most Current

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ISBN: 978-0-8247-2893-9
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Product Details:

  • Revision: 2007 Edition, June 20, 2007
  • Published Date: June 20, 2007
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 402
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


The concept of developing a book focussed on the analysis and surgical treatment of soft-tissue deformities of the craniofacial skeleton originated in a meeting of the American Society of Maxillofacial Surgeons. It has been long recognized that craniofacial and maxillofacial surgery, which included the management of congenital anomalies, facial bone fractures, as well as tumor involvement of the face and skull, have primarily centered around the correction of the bone abnormalities. Tremendous advances have been made, with input from abroad and the United States, including the work of Drs. Paul Tessier, Fernando Ortiz Monasterio, Daniel Marchac, Jacques Van der Meulen, Jacques Marquis Converse, Milton Edgerton, Joseph McCarthy, and others. The success of the bony work was so great, however, that it overshadowed another area of expertise in the plastic surgeons' treatment armenamatarium, namely, the correction of softtissue anomalies of the craniofacial region.

This book is organized to highlight some areas of specific focus of plastic surgeons in this area. It is arranged so that both reconstructive and aesthetic considerations in the treatment of soft-tissue anomalies are addressed. Admittedly, virtually all soft-tissue anomalies also have a bony component to them, but, for this presentation, it is intended that the emphasis be almost solely on the treatment of soft-tissue anomalies rather than the bony abnormalities. As the reader is aware, the issue of correction of bone abnormalities has been addressed in multiple other publications in the past.

The beginning of the book describes conditions involving the scalp, followed by eyes and periorbital structures, ears, nose, midface, and then the lower face. It is clear that with the introduction of many techniques, such as tissue expansion and microvascular transfer of soft tissues, a number of major advances have been made. It is also interesting to note that use of local flap tissues, long considered the province of the plastic surgeon, is now regaining additional emphasis, particularly when used in combination with expansion techniques. Interest in reconstructive surgery for problems in the craniofacial region continues to expand to include nasal reconstruction following cancer involvement, ear reconstruction for congenital anomalies, lip reconstruction following tumor ablation, and congenital anomalies. On the other hand, more recently, due to the marriage of reconstructive techniques with aesthetic concerns, a greater sophistication of aesthetic techniques amenable to reconstructive problems and further improvement in aesthetic and reconstructive abnormality results have evolved.

In short, there is "cross talk" between reconstructive and aesthetic surgery in the management of irregularities in the face and neck, and these are highlighted individually. It is anticipated that evolution of these techniques will continue. Clearly, we have not solved all the soft-tissue anomalies in the head and neck region. In fact, we think the soft-tissue abnormalities present the greatest challenge for craniofacial plastic surgery in the future. With the development of bone remodeling techniques, both osteotomies and stabilization, reshaping, and replacement have become more predictable. What has not been as effectively corrected are the anomalies related to the soft-tissue deformities, particularly traumatic and congenital anomalies. As the face is the feature of human anatomy most emphasized in aesthetics and normal social behavior, it behooves us to identify ways in which we can improve techniques for dealing with anomalies so that the patient may have improved quality-of-life.

The intent of this book, then, is to highlight the current practices in the management of these particular areas and to subsequently spur all of us into developing improved solutions for persistent problems.