EN
The face and jaws are function and appearance at once: how a person chews, breathes and speaks, and how they look and feel among other people. So patients come to a maxillofacial surgeon with very different stories — an injury, a congenital feature, a tumour, the consequences of treatment that went wrong. What they have in common is that the cost of a mistake is high, and one wants to be somewhere that takes responsibility for the result seriously.
Why people come to Germany for this
Maxillofacial surgery in Germany is organised differently from many countries, starting with the doctor’s training. Here it is a speciality of its own at the meeting point of medicine and dentistry: to become a maxillofacial surgeon a German specialist takes two full degrees — in medicine and in dentistry — and only then goes through surgical training. So the person operating on you understands the soft tissue of the face and the way the teeth and the bite work equally well.
That is not a formality. It is precisely on the border between face and jaw that the most difficult cases lie, and the double training makes it possible to solve them as a whole rather than passing the patient between different doctors.
First, an accurate diagnosis and a plan
Before any operation on the face a German surgeon wants to see the exact geometry. CT helps here, including cone beam tomography of the jaws, along with building a three-dimensional model: the operation is planned in advance, before any incision, working out where and how to proceed in order to get the intended result without disturbing anything unnecessary.
Such planning matters especially when the shape or the bite is being corrected: it is visible in advance where the jaw will move to and how that will show in the face. The patient knows what is coming before the intervention.
What is treated and how the approach is chosen
The field is broad and the approach depends on the task. Roughly, the cases fall into several groups.
Facial injuries. Fractures of the upper and lower jaw, the cheekbones and the eye socket are joined and fixed with plates and screws (osteosynthesis) so as to restore both the working of the jaw and the symmetry of the face. Soft tissue and damaged nerves are repaired under an operating microscope — which improves the chance that sensation and facial movement return.
Correction of the jaws and the bite. When the jaws do not meet correctly, that is not only a matter of appearance but of chewing, breathing and the joints. Such operations are done together with an orthodontist and planned in advance on a model.
Tumours. Removal of benign and malignant lesions of the face and mouth is not done single-handedly: the plan is agreed with oncologists and radiation oncologists, and once the lesion is removed, restoring the lost tissue is considered straight away.
Preparing for implants, and reconstruction
A common reason for coming is a shortage of bone for dental implants. If there is too little of the patient’s own bone, it is built up: the patient’s own bone or a bone substitute material is used to create a foundation into which an implant can then be placed securely. It is a preparatory stage but a decisive one — whether the future construction takes depends on it.
The hardest part of the speciality is reconstruction: restoring the tissue of the face after injury or a tumour, or in congenital cleft lip and palate. Here the patient’s own tissue is transplanted, including microsurgically, with the finest vessels sewn together under a microscope. The task is not only to close the defect but to give the face back its natural look and function.
This material is for information only and does not replace a consultation with a doctor. Whether treatment is possible, what it will involve and what it will achieve can be determined only after an examination at the clinic in person.