Role of Camouflage in Management of Facial Trauma Deformities
01 December 2017 (online)
Facial fractures and soft tissue injuries around the eyes, nose, and mouth can be difficult to manage in the primary setting, but if untreated, the secondary correction of facial trauma is very challenging. Prevention of soft tissue contraction by restoring the skeletal framework is ideal. Staged, individualized camouflage techniques can be effective in improving outcomes.
Keywordsscar - fat graft - patient-specific implant - craniomaxillofacial - facial trauma - camouflage - posttrauma deformities
• Secondary traumatic facial deformities are very difficult due to wound contraction, and skeletal remodeling and should be prevented with early, comprehensive fracture reduction, fixation, and soft tissue suspension.
• Three principles to maintain form and function are to (1) preserve soft tissue, (2) restore skeletal framework to prevent wound contraction, and (3) be familiar with soft tissue fine tuning techniques.
• The goal of camouflage of is to achieve facial volume and contour, which is perceived in the normal range by observers.
- 1 Sethi RK, Kozin ED, Fagenholz PJ, Lee DJ, Shrime MG, Gray ST. Epidemiological survey of head and neck injuries and trauma in the United States. Otolaryngol Head Neck Surg 2014; 151 (05) 776-784
- 2 Streubel SO, Mirsky DM. Craniomaxillofacial trauma. Facial Plast Surg Clin North Am 2016; 24 (04) 605-617
- 3 Shaye DA, Tollefson TT, Strong EB. Use of intraoperative computed tomography for maxillofacial reconstructive surgery. JAMA Facial Plast Surg 2015; 17 (02) 113-119
- 4 Phillis M, Ishii M, Dey J. , et al. Measurement of the quality of facial lesion reconstruction with observer-graded affect display. JAMA Facial Plast Surg 2016; 18 (06) 467-473
- 5 Ducic Y. Fat grafting in trauma and reconstructive surgery. Facial Plast Surg Clin North Am 2008; 16 (04) 409-416 , v–vi
- 6 Del Toro D, Dedhia R, Tollefson TT. Advances in scar management: prevention and management of hypertrophic scars and keloids. Curr Opin Otolaryngol Head Neck Surg 2016; 24 (04) 322-329
- 7 Davison SP, Dayan JH, Clemens MW, Sonni S, Wang A, Crane A. Efficacy of intralesional 5-fluorouracil and triamcinolone in the treatment of keloids. Aesthet Surg J 2009; 29 (01) 40-46
- 8 Lin JY, Warger WC, Izikson L, Anderson RR, Tannous Z. A prospective, randomized controlled trial on the efficacy of fractional photothermolysis on scar remodeling. Lasers Surg Med 2011; 43 (04) 265-272
- 9 Pham AM, Greene RM, Woolery-Lloyd H, Kaufman J, Grunebaum LD. 1550-nm nonablative laser resurfacing for facial surgical scars. Arch Facial Plast Surg 2011; 13 (03) 203-210
- 10 Ong MW, Bashir SJ. Fractional laser resurfacing for acne scars: a review. Br J Dermatol 2012; 166 (06) 1160-1169
- 11 Tziotzios C, Profyris C, Sterling J. Cutaneous scarring: pathophysiology, molecular mechanisms, and scar reduction therapeutics Part II. Strategies to reduce scar formation after dermatologic procedures. J Am Acad Dermatol 2012; 66 (01) 13-24 ; quiz 25–26
- 12 Leventhal D, Furr M, Reiter D. Treatment of keloids and hypertrophic scars: a meta-analysis and review of the literature. Arch Facial Plast Surg 2006; 8 (06) 362-368
- 13 Peled M, Leiser Y, Emodi O, Krausz A. Treatment protocol for high velocity/high energy gunshot injuries to the face. Craniomaxillofac Trauma Reconstr 2012; 5 (01) 31-40
- 14 O'Brien DC, Andre TB, Robinson AD, Squires LD, Tollefson TT. Dog bites of the head and neck: an evaluation of a common pediatric trauma and associated treatment. Am J Otolaryngol 2015; 36 (01) 32-38
- 15 Burget GC. Preliminary review of pediatric nasal reconstruction with detailed report of one case. Plast Reconstr Surg 2009; 124 (03) 907-918
- 16 Kim MM, Boahene KD, Byrne PJ. Use of customized polyetheretherketone (PEEK) implants in the reconstruction of complex maxillofacial defects. Arch Facial Plast Surg 2009; 11 (01) 53-57