Alberto Rocha Pereira , plastic surgeon and coordinator of the Unit of Facial Reconstructive Surgery of Hospital da Luz Lisboa, and the Unit of Aesthetic and Plastic Surgery of Hospital da Luz Torres de Lisboa, performed recently two innovative surgical interventions for facial reconstruction and correction in young adults. These surgeries were made resorting to modern technology, such as intraoperative CT, virtual surgical planning and the use of implants and fixing plates produced by 3D-printing specifically for the patient. Besides ensuring higher safety and precision to all procedures, this technology enables to prevent operatory complications and allows faster recovery. The first surgery (bimaxillary orthognathic), on February 12, at Hospital da Luz Lisboa, was initially planned through programs of virtual surgical simulation and, then, performed with surgical guides and 3D-fabricated titanium fixing plates, customized for the patient. The purpose was, on one hand, to correct a maxillofacial anomaly originated by underdevelopment of the upper jaw and conditioning poor dental occlusion, besides affecting the correct functioning of the joint that enables mandibular mobility. In the same intervention, the surgeon performed a rhinoseptoplasty for correction of nasal septum deviation and nasal deformity. The second surgery was performed on March 11, also in the operating theatre of Hospital da Luz Lisboa. It consisted in the reconstruction of the right orbit to correct the deformity (enophthalmos, or “sunken eye”) and visual disturbance (diplopia or double vision) of a patient in the sequence of a car accident. This was the first intervention of the kind performed in hospitals and clinics of Hospital da Luz network. Planned using a virtual simulation program, it was performed in two stages: the first for the removal of plates and bolts (misplaced at the time of the first hospital intervention right after the accident), followed by the insertion of a specific implant for reconstructing the bone defect, produced by 3D-impression for perfect adaptation. Intraoperative CT was used to confirm the correct positioning of the implant. In both cases, the recovery of the patients went well and the final result, both functional and aesthetic, corresponded to what was planned and expected. There was also a significant reduction of the operatory and anaesthetic times, with a decisive impact in pain reduction and higher comfort for patients in post-operative period. Alberto Pereira was one of three international specialists in cranio-maxillofacial surgery that participated as guest speakers in Davos, in December 2019, during the training courses promoted by the prestigious AO Foundation over the past 60 years. The AO is the largest association of world surgeons and these courses are organized annually, with the presence of about 1500 participants (besides those who attend online), involving the top specialists dealing with trauma and the treatment of musculoskeletal system lesions (orthopaedists, plastic and maxillofacial surgeons, neurosurgeons and otorhinolaryngologists, among others). In the photo above , the Hospital da Luz Lisboa physician during one of the sessions in Davos.
