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Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
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Craniofacial principles in face transplantation.

Edward J Caterson1, J Rodrigo Diaz-Siso, Pradip Shetye

  • 1Division of Plastic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USA. ecaterson@partners.org

The Journal of Craniofacial Surgery
|September 6, 2012
PubMed
Summary

Face transplantation reconstructs severe injuries by fixating midface allografts. Using the Frankfort horizontal plane ensures precise anatomical positioning for improved function.

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Published on: December 22, 2015

Area of Science:

  • Reconstructive surgery
  • Craniofacial surgery
  • Transplantation medicine

Background:

  • Face transplantation offers solutions for previously irreparable facial injuries.
  • Reconstructions focus on restoring phonation, mastication, and airway function.
  • Midface reconstructions often involve both hard and soft tissues.

Purpose of the Study:

  • To present a novel technique for precise midface allograft fixation in face transplantation.
  • To establish a reliable intraoperative reference for skull base relationship.
  • To improve functional and aesthetic outcomes in face transplant recipients.

Main Methods:

  • Emphasized craniofacial and orthognathic planning for functional outcomes.
  • Utilized the Frankfort horizontal plane as an accessible skull base reference.
  • Developed a technique for midface fixation within Bolton normative data standards.

Main Results:

  • The Frankfort horizontal plane proved to be a viable alternative to the sella-nasion plane for midface positioning.
  • A technique was established for accurate fixation of the midface allograft.
  • Fixation achieved a relationship with the skull base within 1 SD of Bolton normative data.

Conclusions:

  • "Reverse craniofacial planning" enables precise hard tissue fixation in face transplants.
  • This method ensures anatomical restoration of occlusion, speech, and airway function.
  • Achieving precise skeletal relationships is key to successful functional outcomes.