What is Craniofacial Surgery?
Craniofacial surgery is a surgical subspecialty that deals with congenital (occurs before or soon after birth) and acquired (after birth) deformities of the skull, face, jaws, and associated structures. Although craniofacial treatment often involves manipulation of bone, craniofacial surgery is not tissue-specific; craniofacial surgeons are also trained to deal with bone, skin, nerve, muscle, teeth, and other related anatomy.
Deformities often treated by craniofacial surgeons include craniosynostosis (early closure of growth centers of the skull), craniofacial clefts (failure for parts of the face to come together early development in the uterus), immediate and long-term consequences of skull and face fractures, cleft lip and palate, micrognathia (undersized lower jaw), Treacher Collins Syndrome (a genetic disorder that most often affects the cheek bones, jaw, chin, and ears), Apert Syndrome (a genetic disorder that causes fusion of the skull, hands, and feet bones), Crouzon and Pfeiffer Syndrome (a genetic syndrome in which the skull and upper face grow abnormally), Craniofacial microsomia (a condition in which one or both sides of the face is underdeveloped and does not grow normally), microtia (malformation of the external ear) and other congenital conditions. Craniofacial surgeons are also trained in treating other rare genetic conditions of the face that occur before or after birth. Training in craniofacial surgery requires completion of a craniofacial surgery fellowship. Such fellowships are available to individuals who have completed residencies in plastic surgery, oral and maxillofacial surgery, neurosurgery, or otolaryngology. There are also fellowships in craniofacial orthodontics to teach the specialized care and planning required for craniofacial surgery to be done safely and accurately, and in craniofacial pediatrics to learn the wide range of knowledge required for holistic care of the craniofacial patient.
The key to safe and reliable craniofacial care is a well-trained interdisciplinary craniofacial team. Besides craniofacial surgeons, neurosurgeons, craniofacial orthodontists and pediatricians, there are other critical members for high quality care such as nurses, speech language pathologists, geneticists, and anesthesiologists. Craniofacial researchers are members of these specialized teams who explore causes of craniofacial conditions and way to develop future treatments.
Our website offers general information on this subject. It cannot replace an individual medical consultation or referral process. Please contact an experienced specialist in craniofacial surgery in your country for more information.
Choosing the craniofacial team that is right for you can be a truly overwhelming task. There are so many sources of information – doctors, nurses, friends, family, the internet and social media portals, for example – that making a decision can be challenging. Many craniofacial diagnoses require long follow-up and carefully staged interventions over years, making the decision on which craniofacial team to choose even more important.
Our general advice is to take enough time to research, meet and choose the right team and surgeon for you or your child. When meeting a team, be clear about what expectations you have for your craniofacial care so that the team can let you know if your expectations are likely to be met. A prerequisite for a satisfactory surgical result is the choice of an appropriately trained specialist and team who are experienced in the condition you are seeking care. Ask your team about their previous experience with the condition and the expected outcome. Some craniofacial conditions are extremely rare where no single team has seen many patients. For these rare conditions, choosing a large interdisciplinary team who can work together and network with other experienced teams for advice is the best option.
You entrust your life to the health care provider you choose. Every craniofacial surgical procedure involves risks and potential complications. To be confident that your surgeon or orthodontist is experienced in craniofacial surgery a member of the International Society of Craniofacial Surgery (ISCFS) is an intelligent choice.
When you choose an ISCFS member surgeon, you can be confident that your surgeon:
- Is qualified and experienced
- Has a record of safety
- Has demonstrated a commitment to ethical practice
- Is trained in the safest, most up-to-date techniques and treatments
- Is a member of a recognized multi-disciplinary craniofacial team
Because regulations, training and certification processes vary among countries, ISCFS has developed a standardized screening process to ensure that members are properly trained, experienced and qualified. To become an ISCFS member, a surgeon must be:
- A legally qualified, practicing craniofacial surgeon who is active in craniofacial surgery and who has made worthwhile contributions in this field of endeavor
- Actively practicing craniofacial surgery as a part of a multidisciplinary team for a minimum of five years
- A member in good standing of the relevant national organization in the country in which he or she currently resides
- Sponsored by two Active ISCFS members
The prerequisite for a successful operation is a comprehensive discussion about the details of the procedure and your full understanding of possible complications.
Take the opportunity to clarify all important questions. Write down what you want to know. If any questions remain after the discussion, make another appointment, or call your surgeon. Before the procedure, the surgeon will give you a consent form. This will include your personal information (name, date of birth), the type of treatment, and any potential complications discussed. By signing this form, you agree to the procedure and confirm that you have been informed of the risks. In the case of operations to be performed on children, the parent or legal guardian will sign.
You can find competent specialists in your area on this website in the “Find a Surgeon” section (coming soon).
- Ask every surgeon and team member you encounter if they have had focused training in craniofacial procedures, such as a fellowship after their specialty training, and if the team’s craniofacial surgeon has completed an approved fellowship.
- Ask your surgeon how many of these types of patients or procedures they have treated as an independent surgeon?
- If your surgeon recommends surgery, ask if are there any alternatives or any less invasive approaches that yield similar results?
1. How to Find the Right Surgeon?
- Check if the surgeons you are considering are active members of one or more craniofacial societies, either national or international.
- Current addresses of ISCFS member craniofacial surgeons can be found here (coming soon)
2. Who Should Be Your Surgeon?
- It is important that you trust your surgeon.
- As a rule, you will be able to recognize during the consultation by the way they provide information and respond to your questions whether they have experience with this procedure. You should feel welcome to ask questions about the technique, your surgeon’s past experience with this technique, about alternative treatments, and about the surgeon’s and the surgical facility’s participation in quality assurance measures, including whether the surgical facility is accredited.
- Your surgeon should fully inform you about the technique, procedure, and risks.
- You should be able to ask any questions and clarify any additional questions that arise later by telephone.
3. Special Caution is Required …
… if the operation is described as completely problem-free and risk-free.
… if new techniques and/or materials are to be used which have not yet been adequately tested or proven.
… if you are offered an operation date that gives you too little time to think about it, or if you feel forced to make an appointment as soon as possible.
… if down payments for the operation are to be made at the initial consultation.