FACIAL SURGERY

Facial trauma, whether from sporting accidents, falls or assault can cause damage to the facial soft tissue or fracture the facial bones. These injuries require expert input from a maxillofacial surgeon to ensure adequate healing and optimised aesthetic outcomes. Deformity and irregularity of the face following trauma or growth abnormalities can be effectively treated by our surgeons. Contemporary imaging techniques and 3D planning software can be very useful, especially if augmentation is required and custom made grafts can be made for the very best aesthetic results.

How we can help

Ben and James have fellowship training in complex facial trauma management and manage acute trauma on a weekly basis in the NHS. Whilst most trauma is managed through Accident and Emergency and the NHS maxillofacial department, assessment and treatment of facial injury is also available via the Guildford Maxillofacial Clinic. We can assess cases for possible secondary correction of facial trauma that perhaps was initially managed conservatively or treated elsewhere. This includes scar revision or facial fractures.

Facial augmentation, often with the help of 3D planning and custom made prostheses is a useful technique to address bony deformities and irregularities of the face.

About the procedure

Depending on the nature of the procedure this can either be undertaken under local anaesthetic or general anaesthetic.

The Procedures

Facial Trauma Surgery

Injury can result in cuts to the facial skin or fractures of the facial bones. Oral and maxillofacial surgeons are experts at reconstructing such injuries, which include broken jaws, cheekbones and eye sockets. These injuries are usually treated acutely but sometimes patients present at a delayed stage requiring correction of an old injury. Mr Gurney and Mr Sloane have a specific interest in this area with fellowship experience managing complex facial trauma cases.

Jaw Recontouring Surgery

Sometimes jaw shape needs adjusting, either due to previous trauma or for aesthetic reasons. This can be done using 3D imaging techniques to plan the optimal outcome by either reshaping the existing jaw bone or inserting custom jaw implants to achieve the desired contour. In order the harmonise facial balance, adjustment of the chin position may be required, either as part of orthognathic surgery when normalising the bite, or as an isolated procedure for aesthetic reasons.

Cheekbone Augmentation

Cheekbones (zygoma) provide the structural support and projection to the mid part of the face and may at times need additional support to correct either underdevelopment due to genetic reasons or to correct an asymmetry due to an injury . Sometimes the effects of ageing can also be slowed by augmenting this area. Augmentation is usually via custom made implants planned using digital scans of the face to allow the highest levels of precision. Sometimes dermal filler of fat injection is also used to achieve the desired result.

Virtual Surgical (3D) Planning

Advances in digital imaging, particularly low dose CT (CBCT) and intraoral scanners have allowed 3D planning using computer software to become safe and routine practice in many aspects of facial trauma reconstruction and corrective jaw surgery. These methods enable the most predictable surgical outcomes in complex cases. Mr Gurney and Mr Sloane have considerable experience using these cutting edge techniques for obtaining the best results for their patients.

Salivary Gland Surgery

Swellings or lumps in the salivary glands are a relatively common problem and are often due to either blockages in the gland such as salivary stones or can be due to growths within the gland. The most commonly affected sites are the parotid or submandibular glands although there are several other smaller saliva glands in the mouth. The vast majority of swellings or lumps are benign in nature but usually need investigation by a specialist such as Mr Gurney or Mr Sloane to establish the exact diagnosis. This often involves an ultrasound scan and sometimes biopsy. Depending on the cause, treatment can be possible with minimally invasive techniques or removal of a gland.