As well as cosmetic surgery, part of my work involves treating facial deformity in children as and adults. The areas I deal with usually involve the skull and the face and these are known as craniofacial deformities.
I have always believed that the management of cosmetic facial problems and the treatment of facial deformity are all part of the same spectrum. That is why I am a member of BAAPS (British Association of Aesthetic Plastic Surgeons) and The International Society for Craniofacial Surgery (ISCFS). All the pioneer’s and active members of this society meet every two years and the seventeenth biennial meeting of the ISCFS was held in Cancun, Mexico last week. A large band of plastic, maxillofacial surgeons, neurosurgeons and some anaesthetists and scientists all congregated for a brief period on the Yucatan peninsula.
While at the conference, I learnt about some important new techniques that can expand skulls to make more room for the brain; surgery to bring eye sockets together in patients where they are too far apart and distraction methods to elongate faces and jaws as well as results of fat grafting in the treatment of facial asymmetry.
One of the important themes at the conference was the problem of outcome-measures following surgery to the face. It is an area of concern both for deformity and cosmetic surgery. How can one prove scientifically that our surgery has made a difference for the better? The most important outcome measure is of course what the patient thinks of it all. It is correlating this with measurable changes in form, which remains a significant problem. What degree of movement or change in volume or shape will result in an acceptable cosmetic result? We are a long way from truly reaching a definitive answer to this but progress is being made.
At the conference, I presented a paper dealt with only a small part of this huge area of research which is taking place all around the world. It was called ‘CT landmarks for the morphological assessment of Unicoronal craniosynostosis’. It was a very specialised paper concerning a new way of measuring angles at the base of the skull to describe the deformity of this rare condition caused by premature fusion of the skull bones in children producing lop-sided faces.
I have come back from my travels a little wiser and more stimulated and now feeling going forward I have more knowledge on how to help and manage my patients. The next IS
CFS meeting will be in 2 years’ time and will be held in Paris – at least it is nearer!