Hemifacial Microsomia All faces are inherently asymmetric but severe asymmetry may be the result of hemifacial microsomia (HFM). HFM can be associated with orbit (eye socket), ear (microtia) and jaw malformations (mandible) as well as facial nerve palsy (facial droop). Weakness in the smile on the affected side may also be seen. Branchial clefts or remnants as well as kidney abnormalities may also be commonly associated. Surgical treatment is aimed at each involved structure, typically beginning with removal of remnants after the age of 6 months. Jaw and soft tissue abnormalities may be deferred until your child has reached school-age, around the age of five, to allow for facial growth. OMENS classification Microtia (small or absent ear) Mandible Malformations Type 1 – vertical shortening of mandible, normal TMJ. Treatment orthodontics, mandible surgery (BSSO or distraction) Type 2 Type 3 – complete absence of TMJ Treatment around age 5: Rib Graft followed by mandibular distraction or free fibula bone graft Soft tissue asymmteries are often treated by fat grafting Asymmetries due to nerve palsy can be treated by Botox to the nerves on the normal side Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your...
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Microtia –(small or absent ear) Malformation of the external ear may require complex reconstruction requiring the use of cartilage from the rib. This reconstruction is usually postponed until a minimum age of eight to allow for growth of the rib cage. A new ear framework is sculpted from the cartilages and buried underneath the skin where the new ear is to be created. Approximately three months later the “new ear” is elevated from underneath the skin and grafted to create the “normal” projection. Prosthethics are also available, however, are prone to fall off and degrade requiring expensive replacements. The cartilage sculpted ear is the preferred “permanent” reconstruction recommended by most plastic surgeons and are more resistant to infections than synthetic ears. Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your...
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Congenital Nevus (moles) A congenital nevus, “mole”, “birthmark”, is a nest of pigmented cells called melanocytes located underneath the skin causing a discoloration. A congenital nevus is present at birth and carries a higher rate of possible conversion to the cancer melanoma. Treatment involves either consistent monitoring at least on a yearly basis with your dermatologist or a complete surgical excision by your surgeon. Most can be removed surgically leaving a thin linear scar. In some instances, if very large, excision may require tissue expanders (balloons) placed to stretch the normal skin to reconstruct the area after the excision, or even several excisions (serial excisions) to remove the nevus in its entirety. Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your...
Read More » Cleft Lip A cleft lip is a defect (gap) between the lip and or nostril edges that may occur commonly in up to 1/1000 newborns. It may often be diagnosed on prenatal ultrasound around 20 weeks of gestation. Surgical repair of the skin, mucosa, nose, and lip muscle occur around 3-4 months of age and may require presurgical molding by a process called NAM. Good aesthetic and functional results can be obtained, however, minor revisions may be necessitated when your child is older (particularly in the nose) due to the unpredictability of facial growth. Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your...
Read More » Romberg’s Disease / Linear Scleroderma Wasting of the facial fat can lead to severe facial asymmetry in patients with Romberg’s disease and Scleroderma. Plastic Surgeons can help augment the facial tissues using fat grafting techniques and occasional large tissue transplants from other areas of the body (thigh and back) and restore facial symmetry. Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your...
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