The surgical art of facial makeover, Volume 1

My interest in facial plastic surgery developed during my third year of dental school, when I was 20 years old. As is common at the university, a student may be inspired by a charismatic teacher to enter a particular field. For me, it was the docent in head and neck cancer surgery who influenced my pursuit of medical school. Permission was needed from both camps (the Dean of the Medical Faculty and the Director of the Dental School) in order to matriculate, but neither side felt that I should combine these studies. I persisted, nonetheless, and in retrospect, I am gratified by the path I chose, despite a considerable increment (11 ½  years) in university training. The very same docent, Eric Fossion, later on amazed me with his dexterity in the handling of soft tissues, as did Hugo Obwegeser (my second mentor) with his command of cranio-maxillo-facial skeletal surgery. Although my next mentor, Ralph Millard, Jr, may aptly be described as a man of few words, he was quite clear on the matter of achieving perfection in aesthetics. His Principilization of Plastic Surgery had a profound impact on my surgical technique, and I continue to instill his spirit in my trainees and fellows. Visits to plastic craniofacial surgeons Paul Tessier and Daniel Marchac, and to the facial plastic surgeon Rudolph Meyer, were a must in the days of postspecialty preceptorships, but these renowned surgeons failed to impress me. Perhaps I was at a point beyond blind admiration. However, I must confess that recent visits with Sam Lam and Daniel Labbé did
succeed in resurrecting the “Aha!” feeling of my first day of training in Zurich. It was there that I assisted the esteemed Milivoj “Vojo” Perko with a unilateral cleft lip repair. After my 1990 appointment as maxillo-facial surgeon in Bruges, I was able to focus
on facial deformity and congenital craniofacial malformations. For 10 years, I combined this forte with cancer surgery and engaged in other outlets for maxillo-facial surgery, such as traumatic injuries, joint disorders, bone atrophy, cysts, and infections. Gradually, with the appointment of new staff  members, I was free to revisit my foremost passion of facial corrective surgery—developmental, congenital, and age-related. Ultimately, all of my efforts with surgical innovations, publications, and various workshops (notably, the renowned “Lobster” course), including presiding over and organizing the 2010 Meeting of the European Association for Cranio-Maxillo-Facial Surgery in Bruges, led me to the University of Brussels as Chair of the European Face Centre.

Many surgeon trainees and fellows have expressed interest in a solid reference book for orthognathic surgery. From my perspective, there are but a few on skeletal facial surgery to recommend, although a plethora exists for soft tissue remodeling. This book is intended for both areas, combining orthognathic and plastic maxillo-facial procedures. As early as 1996, I contemplated its writing, but I remained undecided on the vantage point—for the author or for the reader? While Ralph Millard’s career was centered on his prolific writing, Hugo Obwegeser released his first book in retirement. I have obviously chosen the seasoned route, allowing my skills and experience to appreciably mature. In describing corrective surgery of the skull and the face, Paul Tessier favored the term “orthoproposomorphic.” It literally means “making the shape of the face right” and while diffcult to pronounce, the word says it all.

Surgical corrections of the face typically are under siege, unless dignified by organic, functional rationales. Interestingly, facial enhancements abound in all “primitive” cultures, as social custom—for example scarifications, tattooing, skull deformations, neck lengthenings, and earlobe or lip extensions. Our Western culture has made arbitrary, mind-boggling distinctions in this regard: piercing of the earlobe is normal, but tongue-piercing smacks of rebellion; eyeliner, brow, and lip tattooing are reasonable, but small, artful tattoos of the face are “just not done”; mandibular advancements, blepharoplasties, and rhinoplasties are socially acceptable, but lip augmentations, face-lifts, and hair transplantations are shrouded in secrecy. 

The media do play a part. Television programs, such as TLC’s “Ten Years Younger,” Fox’s “The Swan,” and ABC’s “Extreme Makeover,” unquestionably have softened the stigma and fear of facial surgery. When the German Society of Aesthetic Plastic Surgery boycotted a regional production of “Extreme Makeover,” the motivation very likely was self-interest, rather than public concern. I am convinced that none of the members would decline a sound makeover request.

During my tenure as president of the European Association for Cranio-Maxillo-Facial Surgery, I helped found a Fellowship in Cosmetic and Plastic Facial Surgery program, thereby promoting easier access to comprehensive specialty training and accredited orthofacial programs for young physicians. I sincerely hope that this book will also be helpful to the next generation of surgeons passionate about facial reconstruction.

The culmination of surgical correction of hard and soft tissue facial imperfections in the two volumes is a historical landmark in the field of aesthetic facial surgery - Johan Reyneke, Johannesburg

Unifying the fields of facial plastic surgery and ortho-maxillo-facial surgery under the rubric “Orthofacial Surgery” in a single edition by a single author is a paramount achievement that I believe will be instructive to both the neophyte and the seasoned surgeon interested in the discipline - Sam Lam, Dallas

l certainly want to have a copy of this book in my library, and I would expect that many involved in both plastic and maxillofacial surgery will as well - S. Anthony Wolfe, Miami

Positions

    Professor and head, European Face Centre - MKA dienst, Universitair Ziekenhuis Brussel, Belgium
    Coordinator Cleft & Cranio-Facial Team, Universitair Ziekenhuis Brussel, Belgium
    Coordinator Steering Group Cosmetic Facial Surgery, EAMCFS
    Honorary Consultant Cleft and Cranio-Facial Centre & Professor in Research, KLES, Karnataka, Belgaum, India
    Honorary Member of the Sociedad Española de Cirugía Plástica Facial
    Member of the Board of Directors, Aesthetic and Reconstructive Craniofacial Surgery Foundation, Hyderabad, Andrah Pradesh, India
    Visiting Professor, Univercitat de Catalunya, Barcelona, Spain
    Docent VUBrussels
    Medical Advisory Board Member of the American Academy of Micropigmentation
    Medical Advisory Board Member of the the Hyderabad Cleft Society

Post specialisation

    Fellow Plastic Surgery (University of Miami)
    Board-certified in Maxillo-Facial Surgery (UEMS)
    Diplôme d'université de Chirurgie Maxillo-Faciale et Plastique de la Face (University of Nancy)
    Medical Forensic Expert (University of Antwerp) - Medical Specialist in Insurance Medicine and Medical Expertise (Belgian Ministry of Public Health)