The role of psychiatry in a craniofacial team.

The psychosocial assessment of the child in the context of his family and community is, we believe, an essential factor in the decision for and the timing of major reconstructive surgery. A severe congenital facial deformity does not usually affect a child's body-image, but it can have a great impact on the total self-image (which is related to social reactions). Surgery should be performed ideally before the early school years, when the child is subjected to the most teasing, provided both parents and the patient have realistic expectations and really want the major reconstruction.