Secondary craniofacial management following skeletal correction in facial asymmetry. Application of microsurgical techniques.

Based upon our experience with microvascular reconstruction of facial contour problems in 116 patients, we have developed an operative approach that emphasized both donor site and facial aesthetics and reliably restores symmetry. This allows correction of the obvious facial symmetry along the jawline as well as the more subtle problems in the midface, temporal, and periorbital areas. A state-of-the-art approach for reconstruction of facial deformities should include standard craniofacial techniques with or without bone expansion followed by soft-tissue microvascular reconstruction when required. This marriage of both hard and soft tissue maximizes the aesthetic results by restoring facial harmony in these difficult craniofacial patients.