Facial Reconstructive Surgery
"...I want to thank you with all my heart for all you have done..."
—C.H., facial reconstruction patient
Because our face is a significant part of our identity and because it exists essentially naked, unhidden by clothing, a facial deformity—from disease or trauma—can be a terrible source of unhappiness, embarrassment, or insecurity. Fortunately, restoring a patient's appearance through reconstructive surgery can allow a patient to regain his or her self-esteem and face life with confidence again.
As a result, Dr. Pearson finds facial reconstructive surgery to be one of the most satisfying aspects of his plastic surgery practice—for both patient and himself. This is particularly where he feels that specialization in surgery of the face and neck is so important, since the uniquely recognizable features of one's face require such delicate precision. Likewise, because no two patients' wounds are ever the same in size, shape, or location, reconstruction demands custom-tailored solutions.
In this section, we'll reveal just a hint of what can often be achieved with modern advanced facial reconstruction techniques. (Of course, Dr. Pearson also cares for patients with more common problems such as scar revision and keloids, but the problems featured below highlight some of the more challenging and unusual problems he treats).
Mohs surgery nose reconstruction
Primarily caused by too much sun exposure, basal cell and squamous cell carcinoma are skin cancers that are especially common here in sunny Florida. Mohs surgery (a.k.a., Mohs micrographic surgery) is a technique often used by dermatologists for the removal of these skin cancers. It's often the best technique for removing tumors on the face and is especially useful for the nose. Dr. Pearson is fortunate to have several well-trained dermatologists right in the Orange Park and Jacksonville, Florida area with whom he can coordinate patient care for those requiring Mohs surgery.Facial Reanimation (Bell's palsy or facial nerve injury)
Many times, though, Mohs surgery leaves a significant wound or "defect" that requires advanced reconstructive techniques. That's where Dr. Pearson, as a facial plastic surgeon, gets involved. Thankfully, even very extensive defects can often be returned to a near-normal appearance.
To rebuild a patient's nose, for example, Dr. Pearson often combines a multilayered approach. A patient's own cartilage and bone can be rearranged and transplanted to restore structure and support, while skin and mucous membranes can be transferred and grafted to recreate lining and coverage.
Bear in mind, though, that to achieve the best results, surgery will often require two or three discrete stages several weeks apart with healing periods in between. But as the examples in Dr. Pearson's before and after photos demonstrate, even a shocking deformity can commonly be restored to a natural-looking appearance.
Nasal reconstruction in particular is one of Dr. Pearson's special interests in reconstructive plastic surgery, and he takes great pride in helping patients recover from Mohs surgery, trauma, or disfiguring diseases (e.g., the "saddle nose" deformity of Wegener's granulomatosis.)
When trauma, tumor surgery, or various neurological conditions damage the function of the facial nerve, the result is paralysis of the muscles of the face. The brow droops, the lower eyelid hangs down and away from the eyeball, and the corner of the mouth sags. But complete facial paralysis affects more than just one's appearance—it also affects proper facial function such as closing the eye or preventing drooling from the corner of the mouth.Lip reconstruction
Thus, the goal of facial reanimation surgery is to not only improve appearance, but also improve facial function. And while there is still no perfect solution to a paralyzed face, modern reconstructive techniques can go a long way to improving a patient's quality of life.
Like with most reconstructive surgery that Dr. Pearson performs, reanimating a paralyzed face involves customizing the surgical techniques to the patient's specific situation. The number of techniques and options are too numerous to list here, but commonly include direct brow lifts, gold weight implants for the upper eyelid, lateral tarsal strip suspension of the lower eyelid, nerve crossover grafting, static and dynamic facial slings (using the patient's own muscles and connective tissue, or implants of Alloderm or medical-grade Gore-Tex®), etc.
Our reconstructive photo gallery shows a few examples of what can be achieved, but again, we believe that each patient is best served by uniquely tailoring the approach based on his or her specific concerns and goals.
Another important area of facial reconstruction is that of lip surgery. Cancer of the lip, usually caused by sun exposure or smoking, can frequently require wide excision of the involved tissue. Like with most reconstructive surgery, the goal of lip reconstruction is to reestablish the lip's appearance as well as its function, which includes facial expression, eating, speaking, kissing, and feeling.The discussion above barely scratches the surface of some of the areas of reconstructive surgery of the face. We have found, though, that the results of facial reconstruction can be tremendously gratifying for both patient and surgeon.
When large sections of lip are removed, simply sewing the edges together to close the wound will not work: the result would either be a wound that fell apart from too much tension, a mouth that was too small to open, or a dramatic size mismatch between the upper and lower lips.
Instead, Dr. Pearson uses techniques that transfer adjacent tissue on its nerve and blood supply, sometimes even borrowing from the other lip (e.g., Abbé, Estlander, and Karapandzic flaps). This careful rearrangement of tissue, which sometimes requires two separate stages, can help restore the patient's appearance and function.