Craniofacial Surgeon, Dr. Jennifer Keagle, discusses applicability of craniofacial surgery in everyday Plastic Surgery private practice. The talk encompasses treatment of trauma (both soft tissue and bony), cleft lip and palate, pediatric plastic surgery and aesthetics. The main focus is on use of autologous materials. Primarily concentrating on fat injection with the Coleman microinfiltration technique and bone grafting. Also discusses genioplasty in place of chin implants.

1. Craniofacial Surgery-
from Trauma to
Aesthetics
Jennifer Newman Keagle, M.D
.
Clinical Assistant Professor, UCLA Division of Plastic Surgery
Private Practice, California and Good Samaritan Hospitals
Attending Plastic Surgeon, Cleft Palate Clinic at White Memorial Hospital

2.  What is Craniofacial Surgery?
 Do your homework!
 Craniofacial Surgery in private practice
 Pediatric
 Traumatic
 Orthognathicsurgery
 Aesthetics
 Rhinoplasty
 Genioplasty
 Fat injection
 Breast
 Lips, fold and other wrinkles

3. What is Craniofacial Surgery?
 Head and Face
 Trauma
 Soft tissue
 Bony
 Congenital defects
 Cleft
 Craniosynostosis
 Orthognathic
 “Pediatric Plastic Surgery”: nevi, skin tags, microtia,
prominent ears, scar revisions, NICU consults, etc.
 Cosmetic

4. I try to…
 “use your own „stuff‟”
 Autologous, autologous, autologous
 Remember that foreign bodies can cause
infection and reaction

5. How does one become a
Craniofacial Surgeon?

6. My Training
Medical School
(Northwestern)
4 yrs
General Surgery Residency-UCSF
• 5 yrs (+ 2 yrs basic science research)= 7 yrs
• Board Certification
Plastic Surgery Residency-UCSF
• 2 yrs
• Board Certification
Craniofacial Fellowship-UCLA

7. My Practice
Aesthetic (including Breast
Reconstruction)= 45%
Pediatric
reonstruction=45%
Trauma
reconstruction=10%

8. Do your homework!

9. Why should I go to a
Board-Certified Plastic
Surgeon?
Aren’t you all the
same????

10. Are you my Plastic Surgeon?
“Cosmetic Surgeon”
Dentist
Emergency Room Physician
Internal Medicine
Oral Surgeon
Podiatrist

11. Plastic Surgeon = Cosmetic Surgeon
Cosmetic Surgeon = Plastic Surgeon/

12. DO YOUR HOMEWORK!
Member of the ASPS (American Society of Plastic Surgeons)
and/or
Board Certified by the American Board of Plastic Surgery

13. Craniofacial surgery in
private practice

14. Pediatric

15. Pediatric Plastic Surgery
 Cleft lip
 Cleft palate
 Ear deformities
 Hemifacialmicrosomia
 Lump, bumps, nevi
 Scar revisions

19. Nevi

20. Benign lesions

22. Trauma

23. TRAUMA
 Soft tissue
 Bony
 Secondary reconstruction

24. Soft tissue trauma

25. Bony Craniofacial Trauma

26. Frontal Sinus

27. Orbital

28. Nasoorbitalethmoid (NOE)

29. LeFort I

30. Mandible

31. Zygomaticomaxillary Complex (ZMC)

32. Secondary reconstruction
due to trauma

35. Orthognathic

36. Orthognathic
 “jaw surgery”
 Lefort I (maxilla)
 BSSO (mandible)
 “double jaw” (maxilla and mandible)
 Functional (underbite, overbite)
 Cleft patients (more common with bilateral)
 OSA
 Aesthetic surgery (genioplasty)

42. Aesthetics

43. Aesthetic Surgery
 Usingautologous materials
 Rhinoplasty
 Genioplasty
 Breast
 Lips, folds and other wrinkles

44. Rhinoplasty
Use of cartilaginous grafting
Rib grafts
Osteotomies
Reconstruction vs. aesthetic

47. Genioplasty
 Not a chin implant
 Using your bone to augment or reduce chin
 Fixation with plates and screws
 Outpatient
 Incision hidden in your mouth
 Less infection/less bony erosion

50. Fat Injection
(the permanent filler)

51. Fat injection
 Autologous
 Coleman microinfiltration technique
 0.1cc per pass
 >50% take
 Fat is centrifuged
 Hand liposuction
 Outpatient or in the office
 Reconstructive or aesthetic
 PERMANENT!
 Takes 1-3 sessions for adequate fill

56. Craniofacial surgery in everyday practice
 The Face
 Try to always use autologous: fat, cartilage, bone
 Less apt to use synthetic
 Reconstructive
 Aesthetic
 Kids
 Adults

57. THANK YOU!
Jennifer Keagle, M.D.
O: 213-250-1300
C: 213-505-6012
jnk@drkeagle.com