Facial deformities and their treatment

Even minor facial deformities impose a burden on the personality: the face is vital for its identification of the individual. Defects in facial form cannot be concealed. The origins of most deformities lie in the bony skeleton. They may be either congenital or acquired. In the congenital deformities, form, size and function are disturbed during the course of development, whereas in the acquired deformities parts of the face are lost by surgery or trauma. Occlusion is always affected in deformities of the central and lower thirds of the face. Conversely, massive disturbances of occlusion have repercussions on facial form. Congenital deformities should be corrected early if function is also disturbed, but additional correction is often necessary after growth is complete. If only the proportions of the bony skeleton of the face are affected, the deformity is corrected after the termination of growth. Reconstruction of normal occlusion is essential in the correction of facial deformities. Tissue missing as a result of surgery or trauma is replaced by grafts. Disturbances of development caused by local disease (neoplasia or osteomyelitis) affecting the face constitute an intermediate form of deformity. These defects should receive only functional correction during growth, final reconstruction not being undertaken until it is complete.