Facial Reconstruction

The face carries our identity, our expressions and our voice. We meet the world quite literally face to face. When parts of this facial structure are lost through an accident, a tumour illness or a previous operation, the result is often a considerable psychological burden.

For this reason, our specialists at the SailerClinic devote themselves to this challenge with sensitivity and the highest level of precision, as part of our reconstructive surgery work. Our goal is to restore the natural shape and function of your face as fully as possible.

Reconstructive Surgery of the Face

Facial reconstruction is among the most demanding fields within oral, maxillofacial and plastic facial surgery, and it is called upon wherever the structure and function of the face have been compromised. Drawing on the long-standing experience of our specialists, we can offer you complex reconstructive procedures across multiple disciplines.

Every reconstructive procedure follows a careful, individualised plan developed in close consultation with the patient. Only this approach allows us to ensure an optimal aesthetic and functional outcome.

Frequently Asked Questions

When is facial reconstruction advisable?

Facial reconstruction is advisable whenever an injury, a tumour disease, a previous procedure or a congenital malformation has affected the shape and function of the face to such a degree that conservative measures are no longer sufficient to address it.

Affected patients typically present, for example, with defects following the removal of skin tumours, bone loss after accidents, unsatisfactory results from prior operations, or pronounced asymmetries.

How many operations are needed for a complete reconstruction?

This depends on the defect and its severity. Smaller reconstructions can usually be carried out in a single procedure; more complex reconstructions, by contrast, often require several stages over a period of months or even years.

Is the patient's own tissue used, or are implants employed?

Both are possible, and each has its place. The patient’s own tissue (cartilage, bone or skin) generally integrates more readily with the surrounding tissue and provides stable long-term results. In certain situations, however, implants made of biocompatible materials such as titanium or PEEK, custom-fitted to the face through computer-assisted planning, can be the better option.

When can reconstruction take place after tumour surgery?

Reconstruction is often started immediately after the tumour has been removed, during the same operation. This is particularly the case when defects are clearly defined and the tumour has been excised with certainty. If, however, findings first need to be confirmed pathologically or radiotherapy is planned to follow, the reconstruction is deliberately scheduled at a later point.

What risks are associated with reconstructive procedures?

As with any operation, reconstructive procedures carry the usual surgical risks such as bleeding, infection or impaired wound healing. Microsurgical procedures additionally carry the risk that the transferred tissue may not heal in sufficiently. Through careful preoperative planning and close postoperative monitoring, however, our specialists are able to minimise these risks.

Does health insurance cover the cost of facial reconstruction?

Reconstructive procedures following injuries, tumour diseases or other medically justified indications are usually covered by health insurance. For procedures that lie in a grey area between reconstructive and aesthetic, however, a case-by-case review may be required.

Facial Reconstruction at SailerClinic

Facial reconstruction encompasses all surgical procedures used to restore lost facial structures and thus goes well beyond superficial correction: it can involve cartilage, bone, mucous membrane, nerves, blood vessels, and sometimes entire functional units such as the nose, eyelid, ear or lip.

Rebuilding cartilage, bone and skin

Rebuilding individual tissue types forms the core of facial reconstruction and draws on a range of techniques, depending on the area and the medical indication.

Cartilage reconstructions are usually performed using the patient’s own cartilage, taken from the rib, the outer ear or the nasal septum, and are most commonly used to rebuild the nose, the eyelid and the ear.

For bone reconstructions, autologous bone grafts may likewise be taken from the iliac crest or the cranial vault, or entire bone segments may be transferred microsurgically from the fibula or the shoulder blade. Modern techniques also make it possible to produce custom implants from biocompatible materials such as titanium or PEEK, designed digitally to suit each individual case.
Defects of the body’s largest organ – the skin – are treated by our specialists using direct wound closure, local advancement flaps, skin grafts or free flap transfers from more distant regions of the body. For larger defects, prior skin expansion may be required.

Reconstruction after injuries

Facial injuries can result from a wide range of traumas – traffic accidents, falls, sports injuries, animal bites or burns – and may affect both soft tissue and the underlying bone structures. Facial reconstruction following injury therefore addresses both the restoration of function and the restoration of natural form. In acute care, the initial priority is stabilisation, which often takes place in coordination across several disciplines. Definitive reconstructive procedures then follow either directly or in stages, depending on the pattern of injury, once healing of the primary wounds allows reconstruction to be carried out safely.

Reconstruction after previous operations

Sometimes the outcome of an earlier facial operation does not match expectations. Where functional or aesthetic limitations remain, a secondary reconstruction can substantially improve the result. Such procedures are considerably more demanding than the original operation, however, and therefore call for particular experience and precision.

Reconstruction after tumour removal

The surgical removal of skin tumours such as basal cell carcinomas, squamous cell carcinomas or melanomas is often medically unavoidable. The resulting defects must then be closed surgically, typically using plastic surgery techniques. In many cases, reconstruction can begin during the very same operation in which the tumour is removed, provided the tumour margins can be assessed reliably. For larger or oncologically sensitive findings, however, the main reconstructive step is deliberately scheduled for a later date, so as not to compromise the overall treatment.

Restoring natural facial form

The face is a finely balanced unit of proportions, symmetries and moving components. A reconstruction is only truly successful when the defective area has not only been filled, but the natural form of the face has been restored as far as possible – including expression, skin quality and the characteristic features of the individual.

Wherever possible, the specialists at SailerClinic use the patient’s own tissue with matching skin properties, and place incisions so that they blend into the natural contours of the face. For complex reconstructions, computer-assisted surgical planning with three-dimensional imaging helps us to define the intended outcome precisely before the procedure even begins.

Restoring the natural shape of the nose

As one of the most demanding areas of the face from both an anatomical and an aesthetic standpoint, the nose is reconstructed in line with the principle of aesthetic subunits: our specialists rebuild it section by section, so that the natural transitions between the bridge, the alae and the tip are preserved. For small defects, local advancement flaps or skin grafts are often sufficient. Larger defects call for a layered reconstruction with additional cartilage grafts, restoration of the inner lining, and reconstruction of the outer soft-tissue covering.

Your expert team

Martin Lanzer
PD Dr. Dr. med. Dr. med. dent., eMBA

Specialist in oral, maxillofacial, and facial surgery, clinic director and CEO

Hermann F. Sailer
Prof. Dr. med., Dr. med. dent., Dr. h. c. mult., Dr. sc. h. c. mult.

Specialist in oral, maxillofacial, and facial surgery, founder of the clinic, senior director

Your Face Deserves Excellence

Facial reconstruction is a demanding path, both medically and personally, but a deeply meaningful one. Arrange a confidential initial consultation at SailerClinic, and let us work together to develop a treatment plan in which you feel at ease.

“Now 18 years later, I would like to thank you once again with a big thank you. Thank you! I have never had any more complaints in the past 18 years, simply brilliant....”

R. Friess, Arosa