(732) 460-9566
Southern Ocean Medical Center,
Medical Arts Pavilion
1100 Route 72 West, Suite 306A
Manahawkin, NJ 08050
107 Monmouth Road, Suite 106
Atlantic Executive Center
West Long Branch, New Jersey 07764

Facial Reconstruction Surgery

Facial Fracture Reconstruction, Orbital Facial Surgery, & Maxillofacial Jaw surgery are all commonly performed at Central New Jersey Plastic Surgery. Dr Stephen Chidyllo, board certified New Jersey Plastic Surgeon has completed training in both Plastic Surgery, Dentistry & Craniomaxillofacial surgery. If you are searching for a reconstructive plastic surgeon to treat a facial bone fracture or facial deformity for a prior accident contact our office and review your questions with our staff.  They will be able to schedule your appointment for a consultation promptly.

 

Maxillofacial Surgery and Craniofacial Surgery

As the Chief of Plastic and Reconstructive Surgery at Jersey Shore University Medical Centre, Dr. Stephen Chidyllo works closely with the "Regional Trauma Centre".   Dr. Chidyllo is often consulted by the trauma surgeons to evaluate and treat complicated facial fractures, jaw fractures, orbital fractures and complex injuries which involved both and facial bones and soft tissues of the face.  Dr. Stephen Chidyllo is one of a few board certified New Jersey Plastic Surgeons who has completed training in both Plastic Surgery and Dentistry. After completion of his plastic surgery residency, Dr. Chidyllo  completed additional fellowship training in the fields of Craniofacial and Maxillofacial Reconstruction of both adults and children. This additional extensive fellowship training and experience has provided Dr. Chidyllo with the additional exposure and expertise needed to treat complex maxillofacial and craniofacial injuries.  Dr. Chidyllo’s prior dental training has provided him with the necessary additional knowledge to understand the intricate relationship between the teeth of the upper and lower jaws.  This knowledge of dental anatomy is critical when treating either traumatic facial fractures or cosmetic facial rejuvenation.Dr. Chidyllo is a member of the American Society of Maxillofacial Surgeons, as well as the American Society of Plastic Surgeons.

Maxillofacial surgery  involves treatment of the bony and soft tissue structures of the face. This might involve the: Mandible (lower jaw), Maxilla (upper jaw), Nose and internal nasal structures, Zygoma (cheek bones), Orbits and Orbital floor (bones about the eyes), Frontal bones and Frontal Sinuses (forehead).  Soft tissue structures involve the: Eyelids, Lips, Tongue and facial skin.   Maxillofacial surgery is usually considered as “reconstructive surgery” when the treatment of traumatic injuries is required, such as Facial Bone Fractures after a motor vehicle accident.  However maxillofacial surgery also has an aesthetic or cosmetic component when dealing with issues such as: Chin Implants, Malar Implants (cheek implants) or re-contouring of the facial bones.

Reconstructive maxillofacial surgery can be performed within days of the primary accident, primary surgery.  In some cases, secondary surgery may need to be performed either months or even years after the primary surgery in order to try to improve, change or alter the results which have occurred as a result of healing.   

ORBITAL-FACIAL BONE FRACTURES:

The ocular globe (eyeball) is housed and protected within the bony orbits of the facial bones.  These orbits are made up of 8 individual and distinct bones.  When a patient sustains a blunt traumatic injury to the orbital region it is common that one or multiple of these bones will fracture.  Common injuries which result in orbital bone fractures include:  Sports related injuries such as baseball, or tennis in which one might get directly hit in the eye with a ball.  Traumatic injuries of the orbital region such as involving a motor vehicle collision, work related injury or “punch” to the orbital region.   In all of these cases a CT scan of the face and orbital bones is required as part of the overall medical workup.  It is also recommended that a complete ophthalmology exam be performed to evaluate and rule out any injury to the ocular globe.

If the diagnosis of an orbital bone fracture is confirmed either on physical exam and or CT scan imaging, then Dr. Stephen Chidyllo will review your options either for surgical intervention or close observation of the injury.  If surgical intervention is recommended Dr. Stephen Chidyllo will review the procedure of choice, depending on your individual case for reconstruction of your orbital facial bone fractures.

Read more concerning Dr. Stephen Chidyllo's views on orbital surgery.

ZYGOMA (CHEEK BONE-TRIPOD) FACIAL FRACTURES:

The zygoma is commonly known as the cheek bone.  It anatomically lies between the orbital bone above it and the upper jaw (maxilla) below.  It is similarly commonly fractured by sustaining a direct or indirect trauma or blow to this portion of the face.  In the past the misnomer of “Tripod Fracture” has been assigned to this type of fracture.  Once again a CT scan of the facial bones along with a complete physical exam is required to evaluate and diagnose the facial bone fractures accurately.   If the diagnosis of a zygoma fracture is confirmed, in most cases surgery is required to reposition the facial bone fracture and fixate it to the surrounding stable bones with micro plates and screws.

MAXILLA AND MANDIBLE (UPPER AND LOWER JAWS) FACIAL BONE FRACTURES:

The maxilla (upper jaw) and mandible (lower jaw) are the “teeth bearing” bones of the face.  These are the facial bones in which both the primary (baby teeth) and permanent teeth are formed and located.  Fractures of these bones similarly occur from either direct or indirect blunt force to the facial bones.  Fracture of these facial bones may also be associated with fractures of the teeth or tooth roots within the region of the bony fracture sites.  Upon evaluation of a patient with a fracture of the maxilla or mandible it is commonly noted and the patient reports  that the “teeth do not fit together” correctly.  The patient now has a mal-occlusion due to the fact that several teeth, in either the maxilla or mandible are now contacting the opposing jaw in a different way than they did prior to the accident.

Treatment of fractures of the maxilla and or mandible are most commonly performed with surgical re-alignment of the fractured facial bones and fixating the fractures with micro plates and screws.  It is often required that metal braces be placed on the upper and lower teeth prior to the placement of the micro plates and screws.  These braces, known as Arch Bars, are placed in the operating room and usually removed at the end of the case.  In some cases where the fractured bones are unstable, even after the placement of the plates and screw, the arch bars may remain in place for up to six weeks after the surgical fixation.  This is to provide additional support to the alignment of the bony fractures during the healing phase.  If there are any broken teeth or tooth roots, these may need to be removed either at the time of the facial bone fracture surgery or afterwards.

FOREHEAD, FRONTAL BONE AND FRONTAL SINUSES

The bony support of the forehead is made up of the Frontal Bones.  Within the frontal bones in the region above the nasal bridge (glabella) lies the frontal sinuses.  In cases where the forehead sustains blunt trauma the frontal sinuses are often fractured.  The frontal sinuses have both a front (anterior) wall and a back (posterior) wall.  In cases where both the front and back wall are fractured, this often requires the assistance of a neurosurgeon to assist in the reconstruction of the frontal sinus fracture.  In cases in which only the front wall of the frontal sinus is fractured, Dr. Stephen Chidyllo routinely reconstructs this region with micro plates, screws and often bone grafts.  As in the above cases, a complete CT evaluation of the involved region is required prior to treatment.  The bony fractured segments are realigned and fixated with micro plates and screws.  Fractures of the frontal sinuses may require long term issues which need to be addresses if the drainage system of the sinuses (nasal-frontal ducts) is damaged due to the trauma of the frontal bone fractures.

 

NOSE AND NASAL BONES

Nasal bone fractures are the most common facial bone injured.  Traumatic nasal bone injuries, besides resulting in a crooked nose may result in other issues.  Nasal airway obstruction secondary to nasal septal deviation may result.  In most cases, as long as the patient has no other emergent medical issues,  it is usually recommended to treat nasal bone fractures if the nasal bones are displaced or if they are causing nasal airway obstruction.  Even in cases where the nasal bones and or nasal septum are aligned, straightened and reduced, there is always the  possibility that due to normal healing and scar tissue, further surgery may be required in the future.

 

SECONDARY MAXILLOFACIAL SURGERY AND REVISION SURGERY

Dr. Stephen Chidyllo performs both primary (at the time of the initial injury) as well as secondary (weeks to years after the accident) Facial Bone Reconstruction. Often the facial fractures do not heal in the correct alignment resulting in either a dental deformity (crooked bite) or a dento-facial deformity (crooked face, chin, nose or jaws). This is commonly due to scar tissue and dento-facial forces pulling on the fractured bones during the healing phase. Often it is necessary to surgically re-brake the bones to correct the deformity and rigidly fixate the broken bones into the corrected position with plates, screws, mesh and bone grafts.

Patients seek Dr. Stephen Chidyllo's expertise and services from all areas within the United States and abroad. If you are consulting with Dr. Chidyllo from out of town, you are responsible for bringing copies of all of your radiographs, either the actual films or on CD, to the initial consultation appointment.

 

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