Maxillofacial in Miami, FL

Our board-certified plastic surgeon, Dr. Jeffrey LaGrasso, can help map out your child's reconstructive, craniofacial surgery alongside your team of trusted pediatric physicians, ophthalmologists, and neurosurgeons. As soon as a problem or malformation is recognized, a plan for craniofacial surgery (a type of plastic surgery that corrects and reconstructs the physical malformation or deformity of the skull) may be put in place for children as young as 8 – 9 months of age. Our craniofacial patients are generally first referred to a Cleft-Craniofacial Center or a Children's Hospital to receive a physical exam, followed by a CT scan to confirm a diagnosis. An eye exam by a pediatric ophthalmologist (eye surgeon) and a consultation with a neurosurgeon (brain surgeon) are additionally required.

Miami, FL plastic surgeon, Dr. LaGrasso will privately discuss with you and your family a personalized plan of treatment during a comprehensive consultation in his office. He also performs craniofacial surgery for patients that have experienced trauma or after the removal of benign or malignant tumors. If you or your family member have a need for craniofacial plastic surgery, please contact our patient advisors for a consultation.

The congenital malformations craniofacial surgery entails premature closure of cranial sutures (craniosynostosis), and craniofacial dysostosis (Crouzon, Apert, Saethre-Chotzen, Pfeiffer, Muencke Syndromes and others). Many other syndromes or anomalies are treated as well, such as Treacher Collins Syndrome, Binder Syndrome, hemifacial microsomia, facial clefts, and frontonasal dysplasia.

Benign and malignant tumors as well as congenital growths are treated like neurofibromatosis, fibrous dysplasia, dermoid cysts and vascular malformations.

Dr. LaGrasso will perform cranofacial surgery for primary and secondary craniofacial trauma patients.

Craniofacial surgery is a class of plastic surgery that can dramatically improve the lives of children who have congenital birth defects or others that have experienced trauma. Benefits of craniofacial surgery performed by board-certified plastic surgeon Dr. Jeffrey LaGrasso in Miami, FL include:

• Correcting structural issues in the skull and face
• Improving breathing, speech, feeding, and vision problems
• Alleviating pain and discomfort
• Normalizing head shape and facial appearance
• Enabling normal and healthy development
• Boosting self-confidence
  

As most of our craniofacial surgery patients are 8 – 9 months of age, we will prepare your child for craniofacial surgery six weeks before the actual operation. Your child may begin blood enrichment therapy to build up the quality of his or her blood using medication. Once a week for six weeks, your child may receive an injection of erythropoietin (Procrit®) to increase the number of red blood cells in his or her bloodstream. Your child also will be given iron supplements to help his or her body produce red blood cells. This blood therapy will reduce the need for blood transfusions during surgery, will help your child heal, and recover faster after surgery.

While your child is on the blood enrichment medication, he or she will need to have a blood count draw done at three different points in the therapy process: at the start of the medication therapy, halfway through the therapy, and then at the end of therapy before surgery. The blood test will determine your child’s blood type, a cross-matching blood type, and a red blood cell count. In case your child needs a blood transfusion during the surgery, matching blood from the blood bank will be made available, or you and/or other family members may choose to donate matching blood instead. A cell-saver machine also will be used during your child’s surgery to minimize the need for a blood transfusion and collects the blood lost during the surgery, then cleans and returns it to your child’s body. 

The two weeks before the surgery will be time for you to meet with Dr. LaGrasso again for a preoperative history and physical exam, to ask any further questions, and discuss the surgery.

Craniofacial surgery performed at Jeffrey LaGrasso M.D. is a complex, multi-step procedure. The process starts with comprehensive planning, which involves diagnostic imaging, such as CT scans, to understand the structural abnormalities of the child in detail. Dr. LaGrasso then develops a surgical plan, often utilizing 3D modeling and simulation to predict outcomes. During surgery, Dr. LaGrasso makes incisions in the scalp, skull, or skin, exposing the affected areas. Using specialized tools, he carefully reshape the bones or tissues, moving them into more normal positions. Sometimes, the surgeon may have to use grafts or implants to help rebuild or reinforce the structures. Once the desired corrections are made, the bones and tissues are held in place with plates and screws that are usually made of absorbable material. Finally, Dr. LaGrasso meticulously stitches the incisions closed.

Most craniofacial surgeries last 7 – 8 hours (dependent on the severity and type of reconstruction) in the operating room to fix congenital defects of the skull present at birth or injuries to the soft tissue and bones in the head and neck. The procedure will be performed with the patient under a general anesthesia, and he or she will remain sound asleep throughout the entire surgery. We will, of course, give the family or caregiver of the patient updates when available. The patient will then be taken to a recovery room, where he or she will be closely monitored by our post-operation nurses and medical assistants.  

Yes. After having a 7 – 8-hour craniofacial surgery, your child will stay in the hospital for at least 3 days to be closely monitored by our post-operation nursing staff and Dr. LaGrasso.

One of the most common conditions treated with craniofacial surgery is craniosynostosis, which is the early closing of the spaces between the bones of the skull, resulting in abnormal skull growth. The particular surgery to correct craniosynostosis is called a cranial vault remodeling.

We will prepare for your surgery by assuming that you or you will need a blood transfusion after the surgery. We will also make sure to have a cross-matching blood type available from a blood bank, or family members may choose to donate matching blood as well.

Anesthesia for children, when administered by experienced anesthesiologists in well-equipped hospitals, poses a very low risk. The likelihood of complications from anesthesia in such settings is significantly lower than many everyday risks, such as injuries from driving.

Craniofacial surgery can be highly effective in addressing functional issues such as breathing and eating difficulties, especially when these issues are caused by structural anomalies. The surgery aims to reconstruct or adjust the craniofacial structures, thereby potentially improving airway function and facilitating better feeding and swallowing abilities. Each case is unique, and Dr. LaGrasso will evaluate the specific needs and potential benefits for each patient.

Like any surgical procedure, craniofacial surgery for trauma carries certain risks, including infection, bleeding, scarring, and reactions to anesthesia. Specific to craniofacial trauma, there may also be risks of nerve damage, which can affect facial sensation or movement, and complications related to the reconstruction of complex facial structures. Dr. LaGrasso will discuss these risks in detail, considering the patient's specific condition and the nature of the trauma. Pre-operative assessments and planning are conducted to minimize these risks and ensure the safest possible outcome.

Take the first step towards correcting the shape of your child's skull at Jeffrey LaGrasso M.D. Our staff is always here to listen to any of your concerns before and after the procedure to ensure the smoothest possible experience. Contact us today to schedule your consultation with Dr. LaGrasso at our facility in Miami, FL.