Soft tissue deformity after craniofacial fracture repair: analysis and treatment.
OBJECTIVE
The primary repair of facial fractures requires sufficient subperiosteal dissection and mobilization of soft tissues to permit accurate fracture reduction. Improper repositioning of soft tissues predisposes the site to deformities with subsequent adverse effects on the aesthetics of the final result. The purpose of this paper is to describe these deformities, the modification of surgical approaches to avoid them, and the various techniques for secondary soft tissue reconstruction.


METHODS
The paper reviews the assessment of soft tissue deformity and the principles of soft tissue reconstruction in addressing temporal contour deformity, cheek ptosis, eyelid deformities, and medial and lateral canthal dystopia.


CONCLUSIONS
The morbidity of remote incisions and soft tissue degloving used in primary facial fracture repair can be minimized by using a meticulous technique and precise soft tissue repositioning at closing.
Antonyshyn
O M
OM
Department of Surgery, Sunnybrook Health Science Centre, University of Toronto, H-271, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5. oantonys@globalserve.net
D002610:Cheek / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000145:classification / Q000517:prevention & control / Q000601:surgery; D004210:Dissection / Q000009:adverse effects; D004954:Esthetics; D005141:Eyelid Diseases / Q000145:classification / Q000517:prevention & control / Q000601:surgery; D005147:Facial Bones / Q000293:injuries*; D005151:Facial Injuries / Q000145:classification* / Q000601:surgery; D006801:Humans; D009135:Muscular Diseases / Q000145:classification / Q000517:prevention & control / Q000601:surgery; D011391:Prolapse; D012887:Skull Fractures / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000145:classification* / Q000517:prevention & control / Q000601:surgery; D013703:Temporal Muscle / Q000473:pathology / Q000601:surgery; D000267:Tissue Adhesions / Q000145:classification / Q000517:prevention & control / Q000601:surgery