CRANIOFACIAL SURGERY 2018-07-09T11:34:12+00:00

WHAT IS CRANIOFACIAL SURGERY?

Craniofacial surgery is a subspecialty of plastic surgery in many parts of the world, that encompasses congenital, traumatic, oncological disorders, aesthetic plastic surgery, and defects of the skull, the face and the facial bones. Craniofacial surgery entails very comprehensive surgical procedures, like changing or reconstruction of the facial bones and skull to the smallest procedure in craniofacial surgery, the rhinoplasty.

In order to assess the face in aesthetic plastic surgery it is paramount to understand the facial skeleton, its anatomy and proportion of each individual patient. Understanding facial proportions relates always to the facial skeleton, and not only to the overlying soft tissue of the face. In aesthetic plastic surgery of the face, knowledge about craniofacial surgery is important to achieve a proportionate and aesthetic result.

During her plastic surgery training at Yale, Dr Bianca Knoll was part of one of the leading craniofacial centers in the US. The Yale Craniofacial center was highly specialized in the treatment of non syndromic (i.e. premature fusion of the sagittal, coronal, metopic or lambdoid suture) and syndromic craniosynostosis (Apert’s syndrome, Crouzon’s syndrome, Pfeiffer syndrome, Saethre-Chotzen syndrome). Extensive research has been performed in order to find out which operative techniques are best from a functional (brain development in young patients) and aesthetic aspect. These surgical techniques in craniofacial surgery have been refined, so that they can be performed safely in the appropriate setting. Patients presenting with deformational plagiocephaly, torticollis, hemifacial microsomia, Goldenhaar syndrome, cleft lip and palates, are treated at different at different times in their life to correct the typical entities of their skull and face. Skull deformities, if not treated at an early age, will influence the development of the facial skeleton. Some patients never underwent craniofacial surgery at a young age, because they were not diagnosed, they had no access or the changes were so mild that a surgical intervention was not considered to be necessary. Some craniofacial asymmetries will become more evident as patients become older. Craniofacial surgery can entail at different ages various procedures, like jaw surgery, surgery of malformed ears, surgery of deformed noses and many others.

CRANIOFACIAL SURGERY AND FACIAL RECONSTRUCTION

Reconstructing a face, to make it look more normal, thereby allowing a patient either to develop and grow normally, or boosting their confidence is something extremely gratifying. Since this approach involves a team of multiple specialties in order to obtain an excellent outcome, Dr Bianca Knoll works together with local, national and international colleagues.

Other aspects of craniofacial surgery relates to the treatment of acute trauma and its late sequelae. Injury may involve the facial bones, soft tissue of the face, or both. Patients who already underwent facial reconstruction due to trauma, tumor reconstruction, or cleft lip an palate repair of the suffer from disfigurement. Some patients are just happy that they have finalized all their surgeries and treatments, but some patients suffer from their sequelae from surgery holding them back from living their lives to the fullest socially and professionally. Some patient having undergone cleft lip and palate repair during childhood still present with the typical asymmetries affecting their nose and upper lip. In some cases it will take relatively small corrective procedures to establish a much better outcome and to improve a patient’s life quality.

To learn more about you options contact the office of Dr Bianca Knoll. Dr Bianca Knoll and her team will be happy to discuss and explain all your questions and concerns that you may have in greater detail during your consultation.

CRANIOFACIAL SURGERY AND AESTHETIC PLASTIC SURGERY

Where craniofacial surgery’s influence is often unrecognized is in aesthetic plastic surgery.
The facial skeleton is the base on which all the facial soft tissue contour is built. Sometimes just treating the overlying soft tissue will not lead to the desired effect. An understanding of the craniofacial structures and potentially corrective procedures to complement the more traditional aesthetic plastic surgery procedures is crucial in achieving the optimal outcome from surgery. A classic example is the so-called profile plasty (i.e., rhinoplasty and chin surgery). Other common discussed features in aesthetic plastic surgery affecting the craniacial skeleton are the width and projection of the cheekbones, and lower jaw. The projection of the cheekbones has also an impact on some of the lower eyelid surgery, and facelift surgery techniques.

Alterations of the facial skeleton can be performed in many different ways. Depending on the individual situation and wishes this can range from smaller to more involved procedures. As you can see, craniofacial surgery is a complex field, but also one of the most interesting. Dr Bianca Knoll and her team will be happy to discuss and explain all your questions and concerns that you may have in greater detail during your consultation.

CRANIOFACIAL SURGERY CONSULTATION

During your consultation with Dr Bianca Knoll in Frankfurt, you will learn about the different treatment options. It is the goal of Dr Knoll to give you the most effective and safe operative approach to achieve the desired improvements that you are seeking. Depending on the individual case additional consults and radiographic imaging might be necessary (for example CT-scan of the skull and face (bone windows). In case you have a copy of previously performed x-rays, CT-scans or medical and operative reports, fotos, please bring those with you for your consultation. Depending on your general health, type of craniofacial surgery procedure, and your personal comfort an overnight stay in the hospital will be necessary or preferred. Minor procedures are usually performed in an ambulatory setting. During your consultation Dr Knoll will carefully listen to your concerns and examine you. She will then discuss these findings with you, and explain your available options during your consultation in our Frankfurt office. Dr Knoll and her team will be happy to provide you with further information about your craniofacial surgery procedure and answer your questions during your consultation in our office.

CRANIOFACIAL SURGERY COSTS

The costs of a craniofacial surgery procedure may vary depending on the complexity, length of the procedure and the details involved. Usually there are 3 different costs: the surgeon’s fee, hospital fee, and anesthesia fee.

Depending on if the surgery is considered medical indicated your health care insurance may cover either full or partially the costs. Please contact the office of Dr Bianca Knoll if your insurance may cover the procedure. Aesthetic procedures are not covered by health insurances and therefore VAT will apply. Dr Bianca Knoll’s office in Frankfurt will provide you with a detailed cost proposal including all these 3 different costs after your consultation. The best thing to do is to come in to see Dr Knoll for a consultation. You will be thoroughly examined and provided with all the information you will need, and how much it will cost. You will also receive further information about any type of preoperative testing required and additional information about the procedure. If you wish to have additional information or would like to schedule a consultation please contact the office of Dr Bianca Knoll, we will be happy to assist you.

We totally understand that it can be impractical for some of our out of town / or international patients, to come into Frankfurt, to get a first impression. For these reason Dr Knoll’s office offers the possibility of an online consultation. However, a virtual consultation has it’s limitations, and does not replace an in person consultation.

SCIENTIFIC PUBLICATIONS RELATED TO CRANIOFACIAL SURGERY BY DR BIANCA KNOLL IN FRANKFURT – GERMANY

SCIENTIFIC PUBLICATIONS:
Click here to read full article
Heller JB, Heller M, Knoll B, Gabbay J, Duncan C, Persing JA. Intracranial Volume and Cephalic Index Outcomes for Total Calvarial Reconstruction among Nonsyndromic Sagittal Synostosis Patients
Plast Reconstr Surg, 2008, 121(1):187-195

Click here to read full article
Knoll B, Shin J, Persing JA. The Bowstring Canthal Advancement – A New Technique to Correct the Flattened Supraorbital Rim in Unilateral Coronal Synostosis
J Craniofac Surg. 2005;16:492-497

Click here to read full article
Knoll B, McCarthy TL, Centrella M, Shin JH. Strain Dependent Control of TGF-ß Function in Bone Cells in an In Vitro Model: Biochemical Events Associated with Distraction Osteogenesis
Plast Reconstr Surg. 2005;116:224-233

Knoll B, Karas D, Persing JA, Shin JH. Complete congenital bony syngnathia in a case of oromandibular oromandibular limb hypogenesis syndrome.
J Craniofac Surg 2000;11(4):398-404

Patel A, Knoll B, Persing JA. A Congenital Cleft of the Alar Rim
Plast Reconstr Surg 2009;122(2):67e

SCIENTIFIC PRESENTATIONS:

XIth Meeting of International Society of Craniofacial Surgery (ISCFS), Queensland, Australia, September 2005
– Cranial Volume and Cephalometric Measurements for Sagittal Synostosis – An Age Dependent Result
Heller JB, Knoll B, Persing JA

35th Annual Meeting of German Society of Plastic, Reconstructive, and Aesthetic Surgeons (DGPRÄC), Düsseldorf, Germany, October 2004
– Das “Bowstring canthal Advancement”: Eine neue Methode zur Korrektur des Ra mus Supraorbitalis bei der Unilateralen Koronarsynostose –
Knoll B, Shin J, Persing JA

35th Annual Meeting of German Society of Plastic, Reconstructive, and Aesthetic Surgeons (DGPRÄC), Düsseldorf, Germany October 2004
– Distraktionsosteogenese: Der Einfluss von mechanischer Dehnung auf TGF-ß in osteoblasten –
Knoll B, McCarthy TL, Centrella M, Shin JH

10th International Congress of International Society of Craniofacial Surgery,
Monterey, USA, September 2003
– The Bowstring Canthal Advancement: A New Technique to Correct the Supraorbital Rim in Unilateral Coronal Synostosis –
Knoll B, Shin J, Persing JA

9th International Congress of International Society of Craniofacial Surgery,Visby, Sweden, June 2001
– Intraoral Distraction of the Mandible: Technical Modifications and Preliminary Re sults –
Shin JH, Opin P, Knoll B, Persing JA

3rd International Congress of Craniofacial and Maxillofacial Distraction in Paris, June, 2001
– Influence of Mechanical Strain on TGF-ß Function in Osteoblasts: An in vitro Mo del for Distraction Osteogenesis –
Knoll B, McCarthy TL, Centrella M, Shin JH

ASMS/PSEF Symposium on Craniofacial Surgery: The New Millenium, in New York City, March 2001
– Influence of Mechanical Strain on TGF-ß Function in Osteoblasts: An in vitro Mo del for Distraction Osteogenesis –
Knoll B, McCarthy TL, Centrella M, Shin JH

17th Annual Meeting of the Northeastern Society of Plastic Surgeons in Montreal, September 2000
– Strain Dependent Control of TGF-ß Function in Bone Cells: An in vitro Model for Distraction Osteogenesis –
Knoll B, McCarthy TL, Centrella M, Shin JH

BOOK CHAPTERS:

Knoll B, Persing JA. Craniosynostosis. In: Pediatric Plastic Surgery. Michael Bentz (ed). Appelton&Lange (Vol 1, pp 541-571)

Persing JA, Knoll B. Non-Syndromic Craniosynostosis. In PLASTIC SURGERY Indications and Practice. B Guyuron, E Eriksson, J Persing. K Chung, J Disa, A Gosain, B Kinney, JP Rubin (eds). Saunders/Elsevier

Knoll B, Persing JA. Correction of Malposition of the Orbits. In: Neurosurgical Operative Atlas. Vol 1. Setti S. Rengachary, Robert H. Wilkins (eds).

Knoll B, Persing JA. Blepharoplasty. In: Soft Tissue Surgery of the Craniofacial Region.(pp 211-222) John Persing, Gregory Evans (eds). Publisher.Informa Healthcare Division of Taylor & Francis Group, LLC

Copyright © 2018 Dr. Bianca Knoll. All Images & Photographs All Rights Reserved.
No content or imagery can be used or duplicated without the expressed written consent of Dr. Bianca Knoll