Facial Birth Defects

​Congenital craniofacial deformities, or birth abnormalities of the face are a diverse group of deformities. They can range from small mild defects to disfiguring clefts to skin malformations. Correcting these problems requires experience and expertise from a large multi-disciplinary team specialised in craniofacial care. Many of these conditions require multiple procedures performed over the course of many years.

Most cases of congenital deformities are detected around the time of birth, and treatment is initiated by early childhood at a dedicated children’s hospital. However, some patients may require treatment later in adulthood if they were previously undiagnosed, previously untreated, or for delayed functional or aesthetic problems that remain unresolved by the end of their teenage years.

The commonest deformities seen include:

• Cleft lip and/or cleft palate – a separation that happens in the lip or the palate (roof of the mouth) or both
• Hemifacial microsomia – a condition where the tissues on one side of the face are underdeveloped and small. This mostly affects the ear, mouth and jaw areas.
• Microtia – small or absent ear
• Vascular malformation – a type of blood or lymph vessel growth or birthmark that is present since birth. This tends to grow in size proportionally to the rest of the body, although some types can worsen and become more problematic over time.

Examples of correctable problems in adulthood include:

• Alveolar clefts (separation at the gum ridge) that have not been treated by previous bone grafting
• Residual palatal fistulae (a hole that connects the air space of the nose and mouth)
• Lip or nose deformities that remain despite previous cleft surgery
• Malocclusion (bad bite, where the teeth do not meet when the jaws are clenched together)
• Speech deficiencies that do not improve with speech therapy
• Bone deficiencies of the middle of the face (midface) or jaw
• Small, deformed or absent ear
• Unacceptable scarring from previous surgery
• Unattractive birth marks or discoloured patches of skin

The treatment options for the above include:

• Repair of gaps with bone and/or tissue grafts
• Revision of previous repairs
• Rhinoplasty
• Orthodontics
• Facial contouring surgery, which includes bone surgery, facial implants, and fat grafting
• Tissue transfer
• Lasers for scars and skin abnormalities
• Ear reconstruction to build a new ear

Every patient’s situation is unique and the treatment will be tailored according to each patient’s face condition and desires. Consult with a plastic surgeon early if you feel you may have any of the above problems.