Dr Yun Phua

Craniofacial surgery is a specialised area of plastic and reconstructive surgery focused on the correction of congenital and acquired abnormalities of the skull, face, and jaws. It involves complex procedures to restore both form and function, often requiring a multidisciplinary approach that may include neurosurgeons, orthodontists, and speech pathologists.

Commonly Craniofacial Conditions:
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• Cleft Lip and Palate:
  A common congenital condition where there is an opening in the upper lip and/or the roof of the mouth. Surgical repair improves feeding, speech, and facial appearance.

• Craniosynostosis:
  Premature fusion of one or more skull sutures, leading to abnormal head shape. Treatment involves surgical reshaping of the skull, usually in infancy.
  
• Craniofacial Syndromes:
  Genetic conditions such as Crouzon, Apert, and Treacher Collins syndromes that cause complex facial and skull abnormalities.
• Facial Asymmetry or Hypoplasia:
  Underdevelopment or imbalance of the facial bones, often treated in conditions like hemifacial microsomia or other syndromic presentations.
• Orbital and Midface Deformities:
  Conditions affecting the eye socket or central face, which can impact vision, breathing, and facial aesthetics.
• Trauma and Acquired Deformities:
  ‍Injuries or previous surgeries that result in facial bone loss or asymmetry may be corrected through reconstructive craniofacial procedures.
• Tumour-Related Defects:
  ‍Reconstruction after removal of benign or malignant growths in the craniofacial skeleton.

Paediatric plastic surgery encompasses a broad range of conditions, addressing both congenital and acquired anomalies in children.

• Ear Anomalies:
  These include prominent ears, cryptotia, and congenital ear tags or sinuses.
• Vascular Anomalies:
  These include infantile haemangiomas, low-flow malformations such as venous, lymphatic and mixed venolymphatic malformations, and high flow malformations such as arteriovenous malformations.
• Paediatric Skin Lesions:
  A variety of skin and soft tissue lesions are treated, including congenital melanocytic naevi, dermoid and epidermoid cysts, pilomatrixomas, and neurofibromas.

Surgery for skin cancer involves removing the lesion along with a margin of healthy tissue to ensure complete excision. Reconstruction is often required, especially in visible or delicate areas like the face. This may involve a skin graft, where skin is taken from another part of the body to cover the defect, or a flap reconstruction, where nearby tissue with its own blood supply is used to repair the area. Flaps often offer better aesthetic and functional outcomes. The aim is to fully remove the cancer while restoring appearance and function.

Common aesthetic facial procedures include:

• Rhinoplasty:
  ‍Reshaping the nose for improved nasal appearance or breathing.
• Facelift:
  ‍Lifting and tightening facial tissues to reduce skin excess and signs of ageing. Often combined with tightening excess skin in the neck and may involve fat grafting for volume restoration for areas of the face.
• Blepharoplasty:
  ‍Eyelid surgery to correct drooping upper lids or puffy lower lids.
• Brow Lift:
  Elevates the eyebrows and smooths forehead lines.
• Chin and Jaw Contouring:
  ‍Improves facial balance and profile.‍
• Otoplasty:
  Reshapes prominent or misshapen ears.
• Lip Lift or Augmentation:
  ‍Enhances lip shape and definition.

‍Note that these procedures may be performed individually or in combination to achieve natural, balanced results tailored to each patient’s goals.

Reconstructive microsurgery is an advanced surgical technique used to repair complex defects by transferring tissue (known as a free flap) from one part of the body to another by reconnecting small blood vessels and nerves under a microscope. It is commonly used when simpler methods (like skin grafts or local flaps) are insufficient, particularly after trauma, cancer surgery, or in congenital conditions.

Microsurgery is commonly required in:

• Head and neck reconstruction after tumour removal.
• Limb reconstruction after severe injury or tissue loss.
• Lymphoedema surgery for select patients who may benefit from lymphaticovenous anastomosis or lymph node transfer.