Traumatic Craniofacial Deformity: Late Treatment

Abstract

Traumatic craniofacial deformity should be reconstructed acutely when possible, though it may be done effectively secondarily if certain principles are followed. These principles involve extensive mobilization of the soft tissue for repositioning and reshaping, liberal use of onlay split rib grafts about the orbits, nose, and zygomas, and segmental repositioning of larger bone segments about the jaws and cranium. Simultaneous scar revisions, addition to deficient soft tissue bulk and nose, mouth, and canthal repositioning should be done. Upper eyelid ptosis, strabismus, and nasolacrimal obstruction corrections should be delayed for at least 6 months following major bony reconstructive procedures.