In short. What craniofacial and maxillofacial surgery actually treats, who it is for, how it differs from aesthetic facial surgery, and the honest limits of operating on facial bone.
Key points
- No other bone in the body is assessed by its relationship to another bone.
- That is why the occlusion — how the upper and lower teeth fit — sits at the centre of every maxillofacial plan, and why the orthodontist and the surgeon plan together rather than in sequence.
Craniofacial and maxillofacial surgery is the part of plastic and reconstructive surgery that treats the bones of the face and skull together with the soft tissues that depend on them. It deals with the upper jaw, the lower jaw, the cheekbones, the eye sockets, the palate and the bone that holds the teeth in place. Within the specialty, craniofacial work usually refers to the skull and the growth differences that affect it, while maxillofacial work covers the jaws and the middle of the face.
What it covers
Four broad groups of problems. Congenital differences: cleft lip and palate and the jaw growth problems that follow, and other conditions in which the facial bones form or grow unevenly. Trauma: fractures of the jaw, cheekbone, eye socket and the upper face, which need repositioning so that the bite and the eye position are restored. Acquired deformity: defects left by tumour surgery, infection, radiation, or previous operations that healed in the wrong position. Functional problems: a bite that does not meet, a jaw joint that locks or hurts, a blocked airway, or a jaw so far out of line that eating and speaking are affected.
Who it is for
Most patients arrive with something that does not work, not simply something that does not look right. Growth-related jaw discrepancies usually declare themselves during the teenage years and are best assessed while the skeleton is still forming, though adults are treated at any age once the bone has stopped growing. Fractures are treated at whatever age they occur, and children with a facial difference are followed through a growth pathway rather than a single operation.
The jaws are judged by how they meet
No other bone in the body is assessed by its relationship to another bone. That is why the occlusion — how the upper and lower teeth fit — sits at the centre of every maxillofacial plan, and why the orthodontist and the surgeon plan together rather than in sequence.
What it is not
It is not contouring surgery with a medical name. Removing a small amount of cheekbone or jaw angle to change a silhouette is a different service with different risks, and it is covered on the aesthetic companion site. Nor is it a substitute for orthodontics: moving teeth with braces cannot correct a jaw that is in the wrong position, and moving a jaw cannot straighten teeth. When both are needed, both are planned.
The honest limits
Bone takes months to settle and swelling takes months to resolve; the result is judged at six to twelve months, not at the first follow-up. Numbness of the lip, chin or cheek is a real risk and is sometimes permanent. Infection, delayed healing and the need for a second operation are known complications of facial fracture and jaw surgery. Function comes back faster than appearance, and no surgeon can promise a perfect result.
Arrange a specialist assessment if
- A jaw discrepancy is causing pain in the joint, difficulty chewing, or a bite that has changed over months.
- A facial fracture was treated elsewhere and the bite, eye position or cheek contour is not what it was.
- A child has a facial difference that has not been assessed against a growth and treatment plan.
Frequently asked questions
What does craniofacial and maxillofacial surgery treat?
Four broad groups: congenital differences such as cleft lip and palate and facial bones that grow unevenly; trauma including fractures of the jaw, cheekbone, eye socket and upper face; acquired deformity after tumour surgery, infection, radiation or previous operations; and functional problems such as a bite that does not meet, a locking joint or a blocked airway.
Is this the same as contouring surgery to change a face shape?
No. Removing a small amount of cheekbone or jaw angle to change a silhouette is a different service with different risks. Nor is it a substitute for orthodontics: moving teeth with braces cannot correct a jaw that is in the wrong position, and moving a jaw cannot straighten teeth.
What are the honest limits of surgery on the facial skeleton?
Bone takes months to settle and swelling takes months to resolve, so the result is judged at six to twelve months rather than at the first follow-up. Numbness of the lip, chin or cheek is a real risk and is sometimes permanent, and infection, delayed healing and a second operation are known complications.
Risks & Limitations
- Reconstruction is usually staged — more than one operation is normal, and the plan may change as healing progresses.
- Donor-site scarring and discomfort, including after rib cartilage harvest.
- Partial or complete failure of a flap or graft, which may require further surgery.
- Scars are permanent. They mature and fade but never disappear.
- Asymmetry and the inherent limits of matching a normal side.
- Altered sensation, numbness or weakness in the operated area.
- Contracture, which may need release procedures later.
- Final assessment is made at 6–12 months, and longer in growing children.
When to Seek Care
- A flap or graft that turns dark, cold, black or stops bleeding when pricked.
- Fever above 38 °C, or spreading redness, warmth or discharge around a wound.
- New or worsening pain, swelling or fluid leakage from the operative site.
- Bleeding that does not stop with gentle pressure.
- Any change in a reconstructed area that concerns you, however minor.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — reconstructive surgery guidance
- World Health Organization (WHO) — burn and trauma care resources
- Chinese Medical Association, Plastic Surgery Branch — clinical guidance
- Cochrane Library — systematic reviews in wound and reconstructive care
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.