The secondary correction of post-traumatic craniofacial deformities.

Objective: To analyze the aesthetic and functional outcomes in a large series of patients who underwent secondary correction of post-traumatic craniofacial deformities (PTCD) and to highlight the underlying principles and formulate treatment guidelines.
Methods: A single surgeon's retrospective case series of 57 patients who underwent correction of PTCD.
Outcome Measures: Evaluation by multiple surgeons who assessed aesthetic results and functional parameters after secondary correction of PTCD.
Results: A good to excellent aesthetic outcome was achieved in the majority of patients. Traumatic telecanthus, enophthalmos, and occlusal deformity were the deformities most refractory to secondary correction. Aesthetic results were adversely affected by the severity and number of pre-existing abnormalities and by the presence of established deformities (beyond 6 to 12 months).
Conclusions: The basic principles of treatment include an initial major osseous reconstructive surgery to restore an anatomically correct craniofacial architecture followed by selective ancillary procedures to address soft tissue deficits and functional deformities. Soft tissue deformity is the major deterrent to achieving an ideal outcome.