Before entering higher training, the maxillofacial field requires candidates to be qualified in medicine, dentistry and core surgical skills. Expertise from each field is essential to successful care.
Ongoing training, or residency periods take a number of years, involvement in research is not unusual and maxillofacial surgeons may choose to focus additional time on a sub speciality.
Dedicating a third of a working life to joining a profession is unusual, yet gives us individuals who are able to offer fine support to patients of all ages.
Treatment can encompass corrective surgery for the very young, dealing with cancers in older patients, or facial trauma at any age. The focus throughout is on restoring quality of life and supporting medical needs.
Whilst a good proportion of maxillofacial treatment involves surgery, consultants treat all conditions of the face, head and neck. Non surgical care can be a solution for infections, facial pain, or minor damage.
Diagnostic skills are equally vital. In terms of in depth understanding of cranio-facial systems, or tissues and conditions which affect them, alongside the latest developments, research, techniques.
This includes familiarity with diagnostic equipment, from hand held microscopes, to CT and MRI scans. Valuable aids to help surgeons see the head, or neck in three dimensions and to accurately plan, or carry out surgery.
Above all, consultants are there to care for patients and their overall medical wellbeing is paramount. Every treatment plan and action needs to consider wider effects, maxillofacial care is about health.
The nature of our bodies makes divorcing our mouth and teeth from the rest impractical. They are integral parts and have a broad impact, part of the reason the maxillofacial profession exists.
A further reason is an ability to contribute towards, or carry out complex dental work. This may be the removal of impacted teeth, or buried roots, or aspects of facial reconstruction and repair.
Dental implants can be part of this, along with dental prosthetics, bone grafting, or remodelling. If a surgeon is rebuilding a damaged, or deformed jaw, the ability to restore dental function is essential.
Key skills can be required across cases, such as micro-vascular techniques to transfer tissue, or bone from another part of the body. Trauma can bring unique demands, with delicate fractures, or soft tissue damage.
There are still specific conditions maxillofacial surgeons are renowned for treating:
- Jaw disorders, correcting deformity, misalignment, or issues with the joints.
- The removal of benign, or malignant (cancerous) tumours, cysts and lesions.
- Salivary gland surgery, along with the removal of stones from related ducts.
- Correction of cleft lip and palate, or other congenital, facial deformities.
- Reconstructive surgery, following other treatment, or traumatic damage.
Every case is unique and treatment can have differing reasons. Jaw surgery may be to correct facial disproportion, or relieve facial pain, skin tumours may be cancerous, or psychologically damaging.
Whilst maxillofacial surgery is not as such a cosmetic field, preserving, or improving the way a patient looks is a vital consideration.
Continually moving medicine forward is a core aspect of a maxillofacial consultant’s life. They often act as lecturers, or mentors within the medical profession, sharing skills to benefit patients.
During the coronavirus epidemic, our staff continued to try to take the profession forward. Not least our lead consultant, who as editor of the British Journal of Oral and Maxillofacial Surgery, has worked on new developments in e-learning.
This can support treatment within the public, as well as the private sector. We took an interest in an NHS study of maxillofacial care and offer them support where we are able to.
Part of keeping abreast of developments and seeing them move in a useful direction, including surgical changes. Maxillofacial surgery can be brief day care under local anaesthetic, or under general anaesthetic in a large operating theatre.
Managing the needs of either stems from the confidence and knowledge many years experience bring. There are no shortcuts to a maxillofacial career, because for our patients, there shouldn’t be.