Craniofacial surgical techniques for aesthetic results in congenital and acute traumatic deformities.

The first case of congenital orbital hypertelorism presented demonstrates that complex investigations, careful planning, and extensive experience combined with meticulous attention to detail can turn a severe congenital deformity into normality in one operation. The second case of trauma shows that an acute injury (even in the face of potential major contamination) can be initially managed by utilizing all the principles of craniofacial surgery, thus achieving optimal results in one operation. The surgeon must be prepared to utilize extensive exposures to visualize exact fracture sites and the degree of displacement. Bone grafts must be used to provide contour and to replace missing segments. Direct wiring performed with mechanical efficiency can produce a completely stable skeleton without the need of external devices. Probably the most important factor is that the surgeon should endeavor to achieve complete correction during initial operation regardless of the time taken. The concept of doing some things at a later date is never satisfactory in terms of the quality of result.