Craniofacial Reconstruction Before & After Photos

Manuel came to us with an unrepaired anterior encephalocele. The lining around the brain, and brain tissue itself, extended through the nasal bones to rest outside of the skull.

With a thin layer of skin and soft tissue over the brain, he was at high risk of trauma, infection, visual obstruction, and psychosocial harm.

Through the generous support and guidance of LEAP, Dr. Craig Hobar, and the Cheryl Lamon Memorial Fund, we were able to bring him to the United States and Medical City Dallas to perform the repair.

Dr. David Sacco performed the critical neurosurgical repair, removing nonfunctional brain tissue, and repairing the dura.

With Dr. Evan Beale, we used a pericranial flap, split calvarial bone grafts, orbital bone medialization, canthopexies, and skin tailoring, to provide further bone and soft tissue reconstruction.

He spent a few days in the hospital under close watch. He is seen at 7 weeks here, happy and thriving!

This woman hoped for improved symmetry after extensive previous reconstruction after a car accident.

Anatomic analysis showed insufficient skin and bulk of the upper lid and brow.

The forehead and brow grafted skin was advanced downwards, and filled in with a dermal fat graft to match the normal thickness of eyebrow tissue.

The lower eyelids were softened with fat transposition and fat grafting, to help her feel a little more refreshed using an incision on the inner side of the eyelid.

We agree that it’s a great step, and we look forward to helping offer some hair transplantation and further refinement with small in-office procedures as desired!

This man has had multiple craniofacial reconstructions including monobloc and LeFort III distractions in the past.

He came to us to correct his anterior open bite so that he could chew and speak more normally.

We were also able to improve his facial profile and balance, and he is breathing better now.

He is seen here at 6 weeks, with plans for further orbital and nasal reconstruction in the future.

This child with #CrouzonSyndrome unfortunately did not reach us until after he had lost his sight due to increased pressure inside his skull.

Previous efforts at another center to expand his skull and relieve the pressure with a shunt were unable to prevent blindness.

However, we did feel we could improve his midface hypoplasia (underdevelopment of the middle area of his face) with #distractionosteogenesis.

This was planned as a combined zygomatic repositioning and #LeFort II distraction.

In sequence, this was the same technique as a #LeFort III advancement and fixation, and then performing the LeFort II separation of the nasomaxillary segment with subsequent #externaldistraction to telescope the central area out even further.

While I usually prefer an internal distractor for a Lefort I, using the halo allowed for more control of the distraction in multiple planes, and for fixation against the cranium. #VirtualSurgicalPlanning helped guide us to the thickest bone on the cranium while avoiding the shunt in place.

He is seen here after removal of the distractor. Ideally we can now let him continue without any further surgery until skeletal maturity. At that point, I expect definitive #JawSurgery will be needed.