Secondary craniofacial surgery for trauma

Injuries to the face may leave long-term defects with both aesthetic and functional consequences. This holds true especially when treatment is delayed, inadequate, or absent altogether. The wide spectrum of posttraumatic deformities leaves the surgeon with a formidable challenge of reestablishing harmonious facial contour and proper function of each craniofacial unit. Camouflage techniques may be used to correct minor deformities whereas osteotomies and repositioning of segments are needed for more complex problems. Bone replacement is often required as part of the treatment. Although autograft bone is the gold standard, bone substitutes can provide acceptable results. This article focuses on posttraumatic defects of the fronto-orbital region as well as those involving occlusion. Basic principles applying to facial harmony, bone healing and grafting, dental occlusion, and surgical correction specific to each region are discussed.