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Cosmetic Surgery

Maxillofacial Surgery

Generality

Maxillo-facial surgery is the medical-surgical branch specializing in the diagnosis and treatment of diseases and injuries involving the skull, face, mouth, jaw, jaw and / or neck.

In Italy, maxillofacial surgery is a surgical specialty, just like cardiac surgery, neurosurgery or general surgery.

Its field of action is very broad and includes: the operations of dento-alveolar surgery, the removal of cysts or tumors located in the mouth or in another part of the face, the operations of aesthetic facial surgery, the fractures of the jaw or mandible, orthognathic surgery operations, repair of malformations such as cleft lip etc.

The most complex maxillo-facial surgery operations require special preparation.

Duration, healing and recovery times and risks of the operation depend on the type of surgery.

Thanks to the modern instruments and the remarkable abilities of current surgeons, maxillo-facial surgery operations have more than good chances of ending positively.

What's this?

Maxillofacial surgery is a medical and surgical discipline specialized in the diagnosis and treatment of diseases and injuries, affecting the skull, face, mouth, jaw, jaw and / or neck .

Skull, face, mouth, jaw, jaw and neck constitute the so - called cranio-maxillo-facial complex .

IS IT A SURGICAL SPECIALTY?

In Italy and in most of Europe, maxillo-facial surgery is a surgical specialty, like general surgery, cardiac surgery, neurosurgery, plastic and reconstructive surgery, etc.

In countries like the United States, Canada, Australia or Israel, however, it represents a dental specialty (ie dentistry).

WHO IS THE MAXILLO FACIAL SURGERY SPECIALIST?

As can be guessed, the surgeon specialized in maxillofacial surgery is called the maxillofacial surgeon .

Indications

The fields of action of maxillofacial surgery are innumerable.

In fact, the list of possible tasks for a maxillofacial surgeon includes:

  • The operations of dento-alveolar surgery, such as the extraction of decayed teeth for which there is no possibility of recovery, the removal of included teeth, the extraction of teeth no longer vital, the installation of dental prostheses, the installation of dental implants or treatment of dental granulomas and dental abscesses;
  • Removal of cysts or tumors located in a part of the face, in the mouth, on the jaw or on the jaw;
  • Biopsies of cysts or tumors located in the mouth;
  • The treatment of fractures of the jaw or jaw ;
  • Surgery operations concerning the temporomandibular joint ;
  • Surgery operations aimed at modifying the shape and size of facial bones ;
  • Orthognathic surgery operations. Orthognathic surgery is the branch of medicine whose main object is the anomalies and dysfunctions of the jaw;
  • Surgical reconstruction of parts of the face (ex: lips);
  • Surgical repair of congenital malformations of the mouth, such as cleft lip (or cleft lip or cleft lip ), cleft palate or cleft lip ;
  • Surgical repair of congenital anomalies of the cranial vault, such as craniosynostoses ;
  • The cosmetic surgery operations that have as their object parts of the face (eg: nose, mouth, ears, eyes, etc.). Among the most well-known cosmetic surgery operations performed by a maxillofacial surgeon, the following are worth mentioning: otoplasty, blepharoplasty, rhytidectomy, rhinoplasty, genioplasty, oculoplasty and liposuction of the neck.

It should be pointed out that the above list contains examples of invasive operations, or in any case very delicate from an executive point of view, and examples of minimally invasive and not particularly complex operations.

Preparation

While less invasive maxillofacial surgery operations require only a few pre-operative attentions, all delicate maxillo-facial surgery operations of a certain executive complexity require a very specific preparation.

This preparation generally consists of:

  • An accurate medical history . It is useful for the doctor to know the general state of health of the patient, his past pathologies, etc.
  • Diagnostic tests for the measurement of vital signs . These include blood pressure measurement, blood tests and the electrocardiogram.

    They are useful to the doctor to understand if the patient is able to face surgery.

  • Radiological investigations (nuclear magnetic resonance, X-rays, CT scans, etc.). They are used by the doctor to understand and clarify the exact anatomy of the future intervention site.

    They are also useful tests for less invasive operations.

  • The suspension of any drug treatment based on anticoagulants (warfarin and derivatives) and / or anti-aggregants (aspirin and derivatives). By diluting the blood, these medicines are a factor favoring bleeding, in the case of wounds, surgical incisions, etc.

    This preparatory measure is also valid for less invasive operations where there is a need to engrave a portion of tissue.

  • Full fast presentation, on the day of the intervention, from at least the previous evening. Patients are required to follow fasting whenever the operation, which they are about to face, involves general anesthesia or local anesthesia associated with strong sedation.

Procedure

As a rule, maxillofacial surgery operations include, in this sequence, the patient's accommodation in a special bed or in a special chair, the realization of sedation and anesthesia and, finally, the execution of the true intervention is exactly.

OPERATING OFFICES AND ENVIRONMENT

In general, maxillo-facial surgery operations are located in the operating rooms of clinics or hospitals, or in the best equipped dental offices.

The most important aspect of the environments assigned to maxillo-facial surgery is their sterilization and maintenance of their sterilization ( surgical asepsis ).

Maxillo-facial surgery instruments:

  • Dental surgical file for bones
  • hemostat
  • Scalpel
  • Surgical curettes
  • Surgical forceps
  • Surgical scissors
  • Suture scissors
  • Porta-needles
  • retractors
  • opener
  • Surgical Mallet
  • Surgical drills

DURATION OF OPERATIONS

The duration of maxillo-facial surgery varies according to the type of surgery.

There are, in fact, very long types of intervention, which also require several hours, and types of intervention of short duration, which do not exceed 60 minutes.

POST-OPERATIVE PHASE AND RECOVERY

The post-operative phase and the recovery from a maxillo-plastic surgery operation depend mainly on the invasiveness of the procedure. In fact, the more invasive an operation is, the more the post-operative phase and recovery require attention, time and rehabilitation therapies.

It should be remembered that the use of general anesthesia (NB: it is used in more invasive or more complex operations) makes hospitalization of the patient indispensable; this admission must have a minimum duration of 24 hours.

Risks and complications

The maxillo-facial surgery presents the classic risks of any surgical practice, plus those that characterize each specific operation (specific risks).

Risks of surgical practice in general:
  • Infections
  • hemorrhage
  • Adverse reactions to anesthesia
  • Prolonged pain
  • atelectasis
  • Formations of blood clots
  • Confusion

Contraindications

The contraindications to maxillo-facial surgery depend on the type of surgery.

For some operations, the list of contraindications is minimal; for other procedures, however, it includes different health conditions.

Results

Thanks to the continuous progress of medical and surgical technology, which provides ever more efficient and practical tools, today's maxillo-facial surgery interventions have a high probability of ending positively.

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