Open Traditional Craniofacial Surgery

At times, an open cranial vault reconstruction, or a larger, more traditional calvarial or skull remodeling is needed.  The traditional skull remodeling surgery takes about 4- 6 hours and is often done with a team of surgeons.  Plastic surgeons, oral-maxillo-facial surgeons (OMFS) and neurosurgeons often operate together.  The bones of the skull are removed completely or in part, and then the whole or part of the skull is reshaped and recontoured.  The bones are held together with suture, wire, plates and/ or screws.  These devices may be permanent or absorbable.

When a total calvarial remodeling is done, there is often swelling associated with the surgery.  Because of IV fluids, and blood, that collects under the skin, the child’s eyes may be swollen shut for a few days.  Once the swelling goes down, the child is again able to open their eyes.

In these surgeries, the children almost always go to the pediatric ICU after surgery.  The children are watched carefully in the pediatric ICU for several days.  Blood tests may be done to check electrolytes or salts in the blood, hemoglobin and/ or hematocrit.  Since blood loss may occur during surgery, and the baby’s blood gets diluted with IV fluids, sometimes babies need a transfusion during or after surgery.  If you are interested in donating blood before your child’s surgery, please let your surgeon know at least 4 weeks in advance.  Additionally, there are blood saving techniques that most surgeons use, to limit blood loss during surgery. It is important to talk to your surgeons, so that you fully understand the procedures planned for your child.