Hemifacial microsomia is a congenital condition where the lower half of one’s face is underdeveloped. During the 6-8 week of pregnancy the embryological development of the first and second branchial arches is affected. Hemifacial microsomia affects the development of the ear, the mandible and the overlying soft tissue of the face. Hemifacial microsomia varies in severity, ranging from severe forms presenting with severe notable asymmetry of the face, missing external ear to very mild or forme fruste variations. Besides the underdevelopment of one lower side of the face, patients can present with skin tags in front of the ear, facial nerve impairment, and hearing problems. Although severe forms of hemifacial microsomia are diagnosed early on in a patient’s life, mild forms, might be noticed but may remain undiagnosed. Hemifacial microsomia is the second common congenital entity after cleft lip and palates.
The goal of hemifacial microsomia surgery is to improve facial asymmetry, restore dental occlusion, and reconstructing bony and soft tissue deficiency. Depending on the severity and the age of the patient, surgery will be performed in several steps. Mandibular reconstruction at a younger age requires a team of specialists to ensure adequate dental occlusion. Ear reconstruction can be performed in children at about the age 5-6 years before entering school. Rib cartilage is used to reconstruct the ear and requires 3 to 4 surgeries being several months apart. The first 2 surgeries are usually the more involved ones, whereas the subsequential surgeries are often less extensive. Restoration of facial volume, may require support of the underlying bony structures and augmentation of the soft tissue volume. Depending on what is being needed, this can be achieved in different ways for example by using bone, implants, or fat transfer.
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.
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 for yourself or your child. Depending on the individual case additional consults and radiographic imaging might be necessary (for example CT-scan of the skull and face (bone windows). If you have a copy of previously performed x-rays, CT-scans or medical and operative reports, or photographs, please bring those with you for your consultation. Depending on your general health, type of surgical 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. Patients struggling with mental health issues attributed to real or perceived asymmetry issues of their face, are not good candidates for surgery. Patients suffering from body dysmorphic disorders, obsessive compulsive disorders, perfectionism, and related mental health issues, are best supported and cared for by a mental health care provider specialized in this area.
The costs of craniofacial surgery related to hemifacial microsomia 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 medically indicated your health care insurance may cover the costs either fully or partially. Please contact the office of Dr Bianca Knoll if your insurance may cover the procedure. Aesthetic considered 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 for an initial consultation. For this reason Dr Knoll’s office offers the possibility of an online consultation. However, a virtual consultation has it’s limitations especially in complex cases like hemifacial microsomia, and does not replace an in person consultation.