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Despite the fact that recent medical advances have improved the quality of life and increased the life expectancy of patients suffering from thalassaemia, no standard strategy or clinical guidelines are available for the correction of the presenting craniofacial anomalies. The aim of the present study is to review the craniofacial features of affected patients, and to discuss the orthodontic and orthognathic surgical treatment options available to manage the associated and characteristic facial deformity.

Parry-Romberg syndrome or progressive hemifacial atrophy is a craniofacial disorder characterized by slow and progressive atrophy, generally unilateral, of facial tissues including muscles, bones and skin. The coup de sabre is a clear line of demarcation seen between the normal and abnormal structures. The severity of the facial deformity is dependent on the age of onset of the disease. Cosmetic management is the only available treatment and has to be delayed until facial growth is completed. The present case report deals with a 43-year-old woman with progressive hemifacial atrophy which started from the age of 10 months. Despite almost complete involvement of the right paramedian area and the early age of onset, she had neither eye changes nor any dental malformations.

Lateral facial cleft is a rare congenital anomaly, but all affected infants require surgery under general anesthesia. Conventional 2-dimensional coronal view of the face, which is typically used for identification of facial clefts, has limitations with regard to detection of this anomaly. We describe a case of prenatal diagnosis of isolated lateral facial cleft made with 3D sonography and highlight the importance of this tool in the diagnosis of this rare facial deformity.

The sinonasal tract is frequently affected by nonneoplastic inflammatory diseases. Inflammatory lesions of the sinonasal tract can be divided into 3 main categories: chronic rhinosinusitis, which encompasses a heterogeneous group of entities, all of which result in mucosal inflammation with or without polyps-eosinophils; infectious diseases; and autoimmune diseases and vasculitides, which can result in midline necrosis and facial deformities. This article reviews the common inflammatory lesions of the sinonasal tract with emphasis on infectious diseases, vasculitis, iatrogenic, and diseases of unknown cause. Many of these lesions can result in midline destruction and result in facial deformity.

Cleft lip and palate is one of the most common congenital anomalies requiring multidisciplinary care. Such anomaly causes many problems such as impaired suckling, defective speech, deafness, malocclusion, gross facial deformity, and severe psychological problems. Cleft of the lip and palate is one such condition that occurs at such a strategic place in the orofacial region and at such a crucial time that it becomes a complex congenital deformity. Pediatric dentist has a vital role to play right from the neonatal period up to phase of permanent dentition. This review describes a vital role played by pediatric dentist, may it be preventive, restorative, or the interventional care. In the present review article, we offer an extensive review of the literature found in the ISI Web of Knowledge, Index Copernicus, SCOPUS, PubMed, and Cochrane Library. The key words searched were “Cleft lip,” “Cleft Palate,” “Cleft lip and palate,' “Dentist,” “Pediatric Dentist” “Pedodontist,” “Management,” and “dental treatment.”

Condylar Hyperplasia (CH) is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH) by mean of single-photon emission computed tomography (SPECT) and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA). After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable. RESUMO A hiperplasia condilar (HC) é uma condição patológica autolimitante que produz deformidades faciais severas devido à assimetria mandibular. Nesse estudo de caso, uma paciente de 15 anos de idade foi diagnosticada com hiperplasia condilar unilateral (HCU), por meio de uma tomografia computadorizada por emissão de fóton único (SPECT) e de um estudo histológico. Uma condilectomia alta no côndilo direito foi realizada para interromper o status ativo da hiperplasia. Um mês após o procedimento, foram realizadas a impacção ortognática de maxilar e a cirurgia de retroposicionamento assimétrico da mandíbula, por meio de abordagem do tipo benefício antecipado. Depois de 10 dias, consultas ortodônticas passaram a ser feitas a cada duas semanas, durante 4 meses. A fase ativa do tratamento durou 14 meses. Excelentes resultados oclusais e faciais foram obtidos e, após 24 meses de contenção, os resultados permaneceram estáveis.

Significant volume deflation and redundant inelastic skin is seen after massive weight loss (MWL). These changes parallel those found with natural aging; thus, patients exhibit accelerated facial aging appearance. A facelift procedure may enhance the cervicofacial contour and reduce the apparent age in MWL patients; nonetheless, fully correcting this facial deformity is challenging. Extensive skin undermining is the most critical aspect of the MWL facelift, as it allows the resection of the excess skin and adequate redraping. This article describes the surgical and medical modifications that need to be considered in the MWL facelift to ensure a successful outcome.

Aim: The objective was to do a comparative study and to evaluate the outcome in overall acceptance for correction of residual facial deformity with autogenous graft versus porous polyethylene implants. Materials and Methods: A total of 16 patients in the age group of ≥15 years irrespective of sex, caste, religion, and socioeconomic status presenting with signs and symptoms of residual facial deformities and who were declared fit for surgery were included in the study. The study patients were further divided into two groups, of eight each. Deformity correction using autogenous grafts was performed in Group A and using high-density polyethylene (HDPE) alloplastic implants was performed in Group B. During the follow-up period, patients' and doctor rating of overall acceptance between autogenous and alloplastic (HDPE) bone grafts was recorded on 100-mm visual analog scale (VAS) on the 2nd day and 7th day and at 3, 6, and 12 weeks. Results: The unpaired t-test is used for evaluation. VAS score at all the follow-up periods above stated was significantly higher in alloplastic group than in the autogenous group for both in patients and doctor evaluation. Conclusion: From the present study, it can be concluded that porous HDPE implants are an effective alternative to autogenous grafts in accordance of overall acceptance for correction of residual facial deformity when proper case selection, exclusion of negative prognostic factors, and meticulous surgical procedure are followed.

Aim: We herein describe the establishment of the Helsinki Vascularized Composite Allotransplantation (VCA) program and its execution in the first two face transplant cases. Methods & patients: The Helsinki VCA program initially required the fulfillment of legal, hospital, financial, and ethical requirements. Thereafter, the assembling of a multidisciplinary team commenced. A team of Plastic, maxillofacial and ENT surgeons comprise the facial VCA team. The protocol involves collaboration with the Solid Organ Transplant (SOT) team, transplant immunology, immunosuppression, microbiology, psychiatric evaluation, well-defined VCA indications and informed consent. Between 2011 and 2017 two patients were selected for transplantation. Both patients had a severe composite facial deformity involving the maxilla and mandible following earlier ballistic injury. Results: Patient 1 was a 35 year-old male who underwent successful near total face transplantation in February 2016 and at 30 months he has a good aesthetic outcome with symmetrical restoration of the central face and good sensory and symmetrical motor functional outcomes. Patient 2 was a 58 year-old male who underwent full face transplantation in March 2018 and at 5 months he has recovered without major problems. Conclusion: A successful facial VCA program requires a well-prepared research protocol, experts from multiple specialties and careful patient selection. The establishment of the Helsinki VCA program required long and thorough planning and resulted in the first two Nordic face transplantation cases. This protocol now forms the platform (as a proof of concept) for other types of vascularized composite allotransplantations. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Radiotherapy is essential for achieving and maintaining local control in head and neck rhabdomyosarcoma patients. However, radiotherapy may cause outgrowth disturbances of facial bone and soft tissue, resulting in facial asymmetry. Several studies have shown that the management of irradiated bones still remains challenging. The possibility of obtaining functional and aesthetic results when managing facial deformities due to radiation therapy with distraction osteogenesis combined with free flaps reconstruction is not common and not well documented in recent literature. In this report, we present the long-term results of distraction osteogenesis and soft tissue reconstruction via microvascular free flap to correct the facial hypoplasia of a young patient who underwent radiation therapy for rhabdomyosarcoma. This is the first presentation of 26 years long-term results in a patient who also underwent free flaps reconstruction as ancillary surgery for esthetic good results.

Este estudo avaliou o impacto da deformidade facial na percepção da dor de pacientes submetidos a tratamento ortodôntico e ortodôntico-cirúrgico. Estudo caso-controle realizado com uma população de indivíduos em tratamento ortodôntico. Casos e controles foram definidos pelo domínio dor física do Oral Health Impact Profile (OHIP-14). O grupo caso (n = 54) incluiu indivíduos que responderam "nunca" a pelo menos uma das perguntas, e no controle (n = 44), aqueles que responderam "raramente e às vezes" com frequência e "sempre" a ambas as perguntas. Casos e controles foram pareados por sexo, idade e condições clínicas na proporção de 1:1. Para a análise dos dados, os odds ratios foram estimados com respectivos intervalos de confiança de 90%. Não houve diferença significativa entre os grupos com e sem deformidades em relação à distribuição dos sexos feminino e masculino (p = 1.000), o que permitiu parear os grupos caso e controle na proporção de 1:1. Pacientes com deformidade facial apresentaram 2.14 (IC90%: 1.08-4.24) vezes mais chance de relatar o impacto na dor física (p = 0.0662). Pacientes com deformidade facial e em tratamento ortodôntico-cirúrgico tem duas vezes mais chance de perceber a dor física.

We describe the successful insertion of a nasotracheal tube following repeated cuff rupture. The patient was a 55-year-old woman with a history of nasal trauma and multiple rhinoplasties, who underwent elective Lefort I osteotomy and bilateral sagittal split osteotomy for correction of skeletal facial deformity. During fiberoptic bronchoscope-guided nasal intubation after the induction of general anesthesia, the tracheal tube repeatedly ruptured in both nares, despite extensive preparation of the nasal airways. We covered the cuff with a one-inch tape, intubated to the level of the oropharynx, pulled the tracheal tube out through the mouth, and removed the tape. The tracheal tube was then backed out to the level of the uvula, and was successfully advanced.

Study Design: A case report with 2 year follow up. Objective: The aim of this paper is to present a case of bilateral TMJ ankylosis with coexisting dentofacial deformity and occlusal cant, and 2 years follow-up evaluation for changes and relapse in the facial skeletal and airway. Methods: The patient was planned preoperatively by computer simulation for bilateral interposition arthroplasty and surgical jigs, coronoidectomy, detachment of masseter and medial pterygoid muscles from ramus, LeFort 1 osteotomy, temporary maxillomandibular fixation, counter-clockwise rotation of the maxillomandibular complex, maxillary fixation and iliac crest graft, reconstruction of bilateral TMJ with custom-made total joint prosthesis, dermal fat interposition in the joint, reattachment of muscles, maxillomandibular fixation, and active physiotherapy. Results: Average ramal length improved by 28.35 mm (81%) in the immediate postoperative and 25.6 mm (73.45%) at 2 years, showing 2.75 mm (4.4%) vertical bone resorption at the angle region. Point A advanced by 1.3 mm, but showed 4.5% horizontal relapse; Point B advanced by 10.2 mm, but showed 9.5% relapse at 2 years. Pogonion advanced by 26.3 mm (70%) but presented 7 mm (10.9%) horizontal relapse; and menton by 28.6 mm (89%) with 5.4 mm (8.9%) relapse at 2 years. The mean mandibular plane angle decreased by 33.5° (42%) after surgery and by 32° (40%) at 2 years. Pharyngeal airway increased by 49% after surgery and by 75.6% at 2 years follow-up. Conclusion: This computer simulated approach for the management of bilateral TMJ ankylosis with facial deformity and occlusal cant improves aesthetics, function and airway in a single surgery, thereby reducing the management cost and time, and deliver precise results.

The aim of this study was to evaluate the accuracy of novel software-CMF-preCADS-for the prediction of soft tissue changes following repositioning surgery for zygomatic fractures. Twenty patients who had sustained an isolated zygomatic fracture accompanied by facial deformity and who were treated with repositioning surgery participated in this study. Cone beam computed tomography (CBCT) scans and three-dimensional (3D) stereophotographs were acquired preoperatively and postoperatively. The 3D skeletal model from the preoperative CBCT data was matched with the postoperative one, and the fractured zygomatic fragments were segmented and aligned to the postoperative position for prediction. Then, the predicted model was matched with the postoperative 3D stereophotograph for quantification of the simulation error. The mean absolute error in the zygomatic soft tissue region between the predicted model and the real one was 1.42±1.56mm for all cases. The accuracy of the prediction (mean absolute error ≤2mm) was 87%. In the subjective assessment it was found that the majority of evaluators considered the predicted model and the postoperative model to be 'very similar'. CMF-preCADS software can provide a realistic, accurate prediction of the facial soft tissue appearance after repositioning surgery for zygomatic fractures. The reliability of this software for other types of repositioning surgery for maxillofacial fractures should be validated in the future.

ResumoObjetivosO objetivo deste trabalho é avaliar o impacto da deformidade dentofacial na autoestima dos pacientes.MétodosEste estudo envolveu 82 participantes, 29 homens e 53 mulheres, com idades entre os 16‐43 anos. O grupo de estudo (pacientes com deformidade dentofacial) incluiu 39 participantes e o grupo de controlo (pacientes sem deformidade dentofacial) outros 43. Para avaliar a autoestima foi utilizado o Inventário de Autoestima de Rosenberg.ResultadosNão se observaram diferenças no indicador de autoestima entre o grupo de controlo e o grupo de estudo. Observou‐se uma proporção maior de mulheres do que de homens em ambos os grupos. Os homens evidenciaram uma autoestima ligeiramente mais elevada que as mulheres.ConclusãoParece não existir impacto da deformidade dentofacial na autoestima dos pacientes, podendo haver outras variáveis a interferir nesta relação. Importa perceber melhor a associação entre a autoestima e a deformidade dentofacial. Sugere‐se a formação dos ortodontistas sobre a avaliação e gestão de variáveis psicológicas dos seus pacientes, havendo fundamento para uma intervenção interdisciplinar no tratamento ortodôntico‐cirúrgico‐ortognático que inclua profissionais de saúde mental.AbstractObjectivesThe purpose of this study is to evaluate the impact of dental‐facial deformity in patient's self‐esteem.MethodsThis study involved 82 participants, 29 men and 53 women, aged between 16 and 43 years. Of the sample, 39 were included in the study group (patients with dental‐facial deformity) and 43 in the control group (patients without dental‐facial deformity). To assess self‐esteem, it was used the Inventory Rosenberg Self‐Esteem.ResultsNo differences were observed in the indicator of self‐esteem between the control group and the study group. We observed a higher proportion of women than men in both groups. Men showed a slightly higher self‐esteem than women.ConclusionIt seems impact of dental‐facial deformity at patients self‐esteem does not exist, and there may be other variables to affect this relationship. It better understand the association between self‐esteem and dental‐facial deformity. We suggest the relevance of training orthodontists about how to assess and manage their patient's psychological variables, going basis for a multidisciplinary intervention on surgical‐orthodontic treatment which also includes mental healthcare professionals.

Ameloblastomas are benign dental tumors, constituting 15% of oral neoplasms, most frequent odontogenic tumor of the jaw. Patient presenting at a late stage usually presents with large swelling with facial deformity. We present a case of 50 years old male who presented with recurrent ameloblastoma on the left side of the mandible causing facial disfigurement and functional impairment. Adequate removal of the tumor required hemimandibulectomy and intermaxillary fixation was done without any bony reconstruction. We would like to focus on the excellent postoperative result with regard to facial symmetry and functional improvement obtained in this case, though the available management protocols differ and are more advanced in current scenario. This case report gives hope and guidance to the surgeons who face difficulty in managing the deforming benign bony tumors due to the unavailability of facility and funds to reconstruct.

A rare case of an adult male with malformation of the skull, face, hands and feet called acrocephalosyndactly or Apert syndrome is presented. Its probable cause, features and treatment is discussed. It is a unique case who survived upto the age of 32 years without any operative intervention and adjusted in the society though he has all the stigmas of the above syndrome. We have concluded and made a point that in the adult sufferer, facial deformity is not so important and urgent for the treatment than syndactyly, which handicaps the sufferer in performing the daily routine work.

Intraosseous hemangioma is a benign vascular neoplasm and seldom affects the mandible. The diagnosis is challenging owing to its unspecific clinical and radiographic findings. Treatment options in children should be elective based on their age, symptoms, and facial deformity. Herein a rare case of intraosseous hemangioma of the mandible in a 14-year-old female is presented.

A case of an unusually oriented fracture pattern and significant disruption of the right Zygomatico-orbito-maxillary complex, with severe comminution and gross displacement of its skeletal components, is described. Wide surgical access to all the fracture sites was provided by a combination of hemicoronal and intraoral surgical approaches. This enabled successful reduction, precise reapproximation, and stable fixation of the multiple displaced fracture fragments. An excellent restoration of the skeletal morphology and orbital volume to their original, preinjury status was achieved, obviating the development of any residual facial deformity, functional deficit or ocular complications.

Poor facial cosmesis resultant from dysgnathias usually accounts for a range of these individuals' psychological and social problems. Disturbances of both esthetics and function are caused by jaw deformity and associated structures' deformity such as malocclusion. The correction of these deformities is one of the most challenging and intriguing aspects of maxillofacial surgery. Despite having become routine only relatively recently, rigid internal fixation has advanced rapidly, its results are consistent and predictable and thus, its knowledge applies in orthognathic surgery besides other areas of maxillofacial surgery. The bilateral sagittal split osteotomy (BSSO) is a common orthognathic procedure performed on the mandible. First described by Trauner and Obwegeser in 1957, modified by Dal Pont and refined by Epker, several modifications of the BSSO have been introduced aiming to enhance surgical convenience, minimize morbidity, and maximize stability. The aim of this article is to review the literature of this technique from the historical perspective and to present a standard operation technique.

Objective Lip cant is a feature of facial deformity and commonly seen in patients with facial asymmetry. Because of its importance in aesthetic assessment, it is necessary to define the perceptions of lip cant and investigate differences in perception between laypersons and professionals. These data were insufficient in the literature. Methods Photographs of 30 male and 30 female individuals with normal faces were collected, and the lip line angles were measured. A composite facial photograph was generated from superimpositions of the normal faces. Lip line angles from 0° to 9° were made, with other facial features remaining unchanged. The test photographs were arranged in random fashion and evaluated by 64 laypersons and 30 professionals. Comparisons and cumulative frequency were performed. Results The lip line angle from the 60 normal persons was 1.20° ± 0.94°. From the composite test photographs, the average first perception of lip cant was 3.25° 1± 1.36° in the laypersons and 1.70° ± 0.69° in the professionals. The average first perception of unacceptable lip cant was 6.40° ± 1.79° in the laypersons and 4.40°1. ± 1.65° in the professionals. Significant differences were found between the first perception and perception as unacceptable lip cant, as well as between the laypersons and the professionals. Cumulative data showed that 82.8% of the laypersons perceived lip cant at 4°, and 17.2% of them felt it aesthetically unacceptable. Few laypersons (1.6%) considered less than 4° unacceptable. Conclusions The data in this study provide helpful information in the evaluation of lip cant. A lip cant of 4° or more could be considered an indication for clinical management.

The development of the craniofacial skeleton is a spatial and temporal process where cranial sutures play a role in the regulation of morphogenesis and growth. Disruption of these cellular and molecular interactions may lead to craniosynostosis, the premature obliteration of one or more cranial sutures, yielding skull growth restriction and malformation perpendicular to the affected suture. Facial deformity and various functional CNS anomalies are other frequent complications. Cranial vault expansion and reconstructive surgery remain the mainstay of treatment but pose an elevated risk of morbidity for the infant. While the etiology of nonsyndromic craniosynostosis remains to be deciphered, gain-of-function mutations in FGFR1-3 and TWIST1 were found to be responsible for more than 3/4 of the most commonly encountered craniofacial syndromes. Animal models have been invaluable to further dissect the role of genes within the cranial sutures and for the development of alternative nonsurgical treatment strategies. In this review, we will present various molecular and pharmacological approaches for the treatment of craniosynostosis that have been tested using in vitro and in vivo assays as well as discuss their potential application in humans focusing on the case of tyrosine kinase inhibitors.

Pseudo Class III malocclusion is a functional imbalance that generally results from premature occlusal contacts that causes a functional anterior displacement of the mandible. These cases, if not treated at an early stage of development, may interfere in normal growth of bone bases, resulting in facial deformity. This paper suggests the selection of an adequate appliance considering the available possibilities for early intervention of Class III malocclusion. The use of the progenic appliance in such dental malocclusion allows correction in a few months and therapeutic stability mesio-positioned mandible encouraging favorable skeletal growth in a child of 5.6 years of age who came to the Postgraduate Clinic of the Latin American Institute of Dental Research and Education (ILAPEO) in Curitiba, Brazil. [ABSTRACT FROM AUTHOR] Resumen (español):La maloclusión pseudoclase III es caracterizada por un desequilibrio funcional que, por lo general, resulta de contactos oclusales prematuros que causan un desplazamiento funcional anterior de la mandíbula. Estos casos, si no son tratados en una etapa inicial de desarrollo, pueden generar interferencias en el crecimiento normal de las bases óseas y resultar en una deformidad facial. Este papel conlleva a la selección de un aparato apropiado, tomando cuenta opciones actuales, para una intervención temprana en el desarrollo de maloclusiones de clase III. El uso del aparato progénico en este tipo de maloclusión, permite la corrección dental en pocos meses y una estabilidad terapéutica de la mandíbula mesio-posicionada fomentando un crecimiento esquelético favorable en una niña de 5,6 años de edad que acude a la clínica de postgrado del Instituto Latino Americano de Investigación y Enseñanza Odontológica (ILAPEO) en Curitiba, Brasil. [ABSTRACT FROM AUTHOR]

PURPOSE: It is easier for us to judge facial deformity when the patient’s head is in anatomic position. The purposes of this study were to determine: 1) if a group of expert observers agree more than a group of non-experts on what is the correct anatomical position of the head, 2) whether there is more variation in the alignment of an asymmetrical face compared with a symmetrical one, and 3) whether the alignments of experts are more repeatable than those of non-experts. SUBJECTS AND METHODS: Thirty-one orthodontists (experts) and 31 dental students (nonexperts) were recruited in this mixed-model study. They were shown randomly oriented three-dimensional head photographs of a symmetrical adult and an asymmetrical adolescent. In a viewing software, the observers oriented the images into anatomical position. They repeated the orientations 4 weeks later. The data was analyzed using a Generalized Linear Model and Bland-Altman plots. The primary predictor variables were experience and symmetry status. The outcome variable was anatomical position of the head. The other variables of interest included time, and orientational direction. RESULTS: There was a statistically significant difference between the measurements completed by experts and non-experts [F(1,60)=14.83, P

Ossifying fibroma is a rare benign bone neoplasm common in middle age, with definite female predominance. Here, we describe a case of an ossifying fibroma in a 36-year-old female, with a right facial deformity. The lesion had been present for almost 10 years. The panoramic image showed a multilocular appearance with scattered radiopacities. Advanced imaging revealed an expansile multilocular lesion with multiple small radiopaque foci and a few dense radiopaque masses. A histopathological examination confirmed the diagnosis. The case represents a non-aggressive form of an immature ossifying fibroma.

Accurate reduction is the key to successful treatment of bone fractures. Complicated zygomaticomaxillary complex fracture, known as one of the most challenging facial bone fractures, is often hard to achieve an accurate reduction, thus leading to facial deformity. In this study, twenty patients with unilateral complicated zygomaticomaxillary complex fractures were included and randomly divided into experimental and control groups, which is with and without the aid of surgical navigation, respectively. The pre- and postoperative imaging data were collected and then analysed using Geomagic Studio 11 software and Brainlab iPlan CMF 3.0. A more precise reduction was showed in the experimental group according to the measurement results of both software programmes than in the control group. In conclusion, surgical navigation showed great value in performing accurate reductions of complicated zygomaticomaxillary complex fractures and restoring facial contour.

An infant aged 17 days was presented to our clinic with inability to open both eyes along with facial deformity. The vitals were found to be normal and no other systemic abnormality was recorded. On ocular examination, the child was found to have bilateral ankyloblepharon along with cleft lip and cleft palate. An urgent examination was done under general anaesthesia which revealed ankyloblepharon involving bilateral eye (figure 1A) barring a small area on the medial aspect of both eyelids. A probe was passed from the small …

We present the clinical image of a 56-year old male who presented with chronic multiple craniofacial discharging sinuses with lytic, sclerotic destruction of facial bones on radiology causing gross facial deformity. He remained undiagnosed for years. The diagnosis was clinched on histopathology as a chronic granulomatous osteomyelitis showing Actinomyces. Keywords: Craniofacial, Granulomatous, Osteomyelitis, Actinomycosis

Background Prefabricated flap is an important technique to reconstruct facial skin defects. There is no any procedure for full facial reconstruction, and we are the first one to accomplish it. Methods Instead of the traditional supraclavicular island flap, we choose nonexpanded flap pedicled by the anterior perforator of transverse cervical artery (ap-TCA) to repair the whole facial deformity. Results Nonexpanded prefabricated ap-TCA flap repaired full facial deformity successfully. Conclusion Nonexpanded prefabricated ap-TCA flap is one of the best options for male full facial deformity patients.