These are defects of the face and head resulting from trauma, which can present as soft tissue and/or bony defects. 

They can present as acute defects soon after injury with or without concomitant life threatening injuries or as delayed presentation, weeks to months after injury.  These defects result in cosmetic disfigurement or functional problems or both. 

Common causes of craniofacial defects are Road traffic accidents, burns specially electric and chemical burns, gunshot injuries, animal and human bites and assault. 

These defects range from loss of soft tissue or bone from any part of face and head like forehead, eyelids, nose, cheek, mouth, and amputation of nose, and ear, avulsion injury to skin and soft tissue of skull,  non-healed wounds to healed area of soft tissue loss of any part of face and head.

Management of these defects depends on their causes, time of presentation, condition of patient and wounds, site and size of defect and available treatment options.

Life threatening injuries are common in this region like brain injury and are dealt with in emergency meanwhile wounds are dealt with wound wash, dressings, antibiotics till patient condition allows for definitive management. 

Amputation of nose and ear and total scalp avulsion can be dealt with reimplantation surgery of placing nose and ear back to their place by micro vascular surgery if brought to hospital early and the amputated part or tissue of scalp is in good condition. (See ear nose recon)

Reconstruction of other defects require skin grafts, loco regional or free flaps (tissue transferred from other parts of the body along with its blood supply)  , bone and cartilage grafts, alloplastic materials and more than one surgeries are required for complex defects.

FAQ

1. What are functional problems associated with facial defects?

Problems of vision, eating, breathing, hearing can occur according to area involved

2. Will the face look the same as before trauma after plastic surgery?

The purpose is to maintain form and function as much as possible. If injuries are severe and complex cosmetic outcomes are reasonable but not best.

3. What are the chances of success in facial defects?

Chances of success are good I expert hands

4. Will there be scars after surgery?

Scar is unavoidable after any surgery but with meticulous technique scar can be minimized.

5. What if nose and ear not reconstructed by surgery?

Prosthesis (custom made nose and ears) can be used after detailed copulation with our plastic surgeon

 

Written by :  Dr. Fahmina

Copyrights: Pakistan association of Plastic Surgeons