Fernando D. Burstein, M.D., F.A.C.S., F.A.A.P.

Board Certified in Plastic & Reconstructive Surgery
Board Certified in Otolaryngology (head & neck) Surgery
Director of the Center of Craniofacial Disorders for CHOA

Located at our Northside Location

Reconstructive Surgery

burstein reconstructive surgeryReconstruction is a surgical specialty to restore function and correct defects and abnormalities of the face and body. Dr. Burstein is a board certified plastic and reconstructive surgeon trained in cosmetic surgery and otolaryngology/head and neck surgery at the University of California, Los Angeles (UCLA), therefore specializes in reconstructive surgery of the face, head, and neck. For patients who have facial abnormalities, either due to trauma, disease, or craniofacial defects (such as cleft lip/palate), Dr. Fernando Burstein utilizes the least invasive and most up-to-date surgical techniques to restore a more natural facial form.

Click on a procedure listed below to read more.

Maxillofacial surgery
Surgery of the Jaw & Teeth / Malocclusion
Surgery of the Chin / Reconstructive Genioplasty
Facial abnormalities / Facial abnormalities in children
Surgery of the Nose / Cleft nasal reconstruction & Deviated Septum
Torticollis
Congenital Disorders
Surgery for Cleft Lip & Palate
Surgery of the Ears / Otoplasty
Craniofacial Surgery
Surgery for Cleft Lip & Palate in Adults
Surgery for Craniosynostosis
Surgery of the Jaw / Mandibular & Maxillary Reconstruction

Maxillofacial Surgery

Maxillofacial surgery is a type of specialty reconstructive surgery used to correct a wide spectrum of diseases, defects, and/or injuries of the face, head, neck, and jaws. As a board certified plastic and reconstructive surgeon with training in Otolaryngology/ Head & Neck Surgery, Dr. Burstein is world renowned for his reconstructive facial work. In 1991 through 1994 and 1997 through 2001, Dr. Burstein served as chief of Plastic and Reconstructive Surgery at Children’s Healthcare of Atlanta. He currently holds position as Medical Director for the Children’s Center for Craniofacial Disorders and is an associate professor for Plastic and Reconstructive Surgery at Emory University. Dr. Burstein has published hundreds of articles on maxillofacial surgery, contributing to worldwide education of this surgical specialty.

Facial Abnormalities / Facial Abnormalities in Children

Whether a child is born with a facial deformity or facial deformities occur later in life as the result of an accident, reconstructive surgery can help correct these deformities an improve a patient’s quality of life. As Medical Director for Children Healthcare of Atlanta’s Center for Craniofacial Disorders, Dr. Burstein specializes in reconstructive surgery of the face, with a special interest in children’s reconstruction. Some common facial deformities include:

Cleft Lip, also known as Hare Lip, is a birth defect where the upper lip is split or separated either in the middle, on one side, or on both the sides. This deformity can be accompanied by misalignment of the jaw, missing teeth, or breathing problems.

 

Cleft Palate is a birth defect where there is a cleft or a split in the palate (commonly called “the roof” of the mouth).

Facial Cleft is a rare defect where the cleft lies in the middle of the face, resulting in skin and bone that may be missing.

 

Craniosynostosis is a congenital defect of the face where the fibrous joints (called sutures) of the skull fuse improperly and prematurely.

 

Plagiocephaly is a facial deformity in which the bones in the forehead and brow area stop growing, resulting in a flattening of one side of the head and prominence on the opposite side.

 

Brachycephaly is a condition characterized by a high and wide forehead region with the eyes abnormally far apart on the head.

 

Trigonocephaly is a facial defect that causes the forehead to become pointed with eyes abnormally close together.

 

Scaphocephaly a condition caused when the suture, or joint of the skull found in the middle of the head prematurely fuses, resulting in a long and narrow skull shape.

 

Microtia affects the ear on one or both sides of the head, causing them to grow improperly. Sometimes this can cause closing of the ear canal (atresia).

 

Deformational Plagiocephaly or a condition caused by repeated pressure to the same area of the head and a subsequent asymmetrical head shape in infants.

 

Vascular Malformations are birth defects affecting the veins and arteries, the most serious type is known as anteriovenous malformations. Other common types are known as lymphangioma and vascular gigantism. Vascular malformations are congenital and increase in size as a person grows.

 

Chin Deformity usually takes 2 forms – an abnormally small chin or unusually large chin.

 

Maxillary (Upper Jaw) Deformity affects the upper jaw. It can be in the form of a vertical maxillary excess, or a condition where the chin is recessed and the face and nose appear abnormally large in the profile.

 

Mandibular (Lower Jaw) Deformity – This type of birth defect affects the lower jaw and can be either mandibular excess (protrusion) or mandibular deficiency (retrusion). Defects of the lower jaw are the most common jaw defects.

 

Birthmarks / Hemangiomas, also known more commonly as port wine stains, are red spots, usually present at birth and tend to fade with age. Severe hemangiomas may need surgical attention involving skin grafting techniques.

 

Hemifacial Microsomia is a facial defect affecting the soft tissues and bones of the mouth, jaw, and ears.

Many of the surgeries required to correct or improve upon these deformities are very complicated and specialized in nature. Often multiple surgeries may be required. While most patients opt to have their facial deformity operated on as an infant or young child, adults can be candidates for reconstructive surgery as well.

Congenital Disorders

Consisting of multiple conditions, congenital disorders are those medical conditions which are present at birth. Often, congenital disorders are genetic and passed down by one or both parents. The severity of congenital disorders varies depending on the nature of the ailment. Some individuals with congenital disorders don’t even know they have them until much later in life; others have very limited life expectancies’ because of their disorder. Besides genetics, other factors that greatly affect the nature and severity of congenital disorders include: the age of the parents, participation in certain activities, and exposure to hazardous chemicals at the time of pregnancy.

Craniofacial Surgery

Craniofacial surgery is a specialty subset of maxillofacial surgery, targeting areas of the skull, jaw, and face affected by congenital abnormalities. Dr. Burstein completed his fellowship at UCLA in craniofacial surgery in 1989 and is now Medical Director for the Children’s Healthcare of Atlanta’s Center for Craniofacial Disorders. Dr. Burstein contributes to the advancement of the latest techniques for correction of abnormalities such as cleft lip, cleft palate, mandibular abnormality, and abnormalities of the skull.

Click here to access research articles authored by Dr. Burstein containing more specific and technical information about Surgery of the Head & Neck.

Surgery for Craniosynostosis

Craniosynostosis is a congenital defect of the face where the fibrous joints (called sutures) of the skull fuse improperly and prematurely. Occurring relatively regularly in one out of every one thousand births, synostosis is remedied by surgery that re-separates the sutures connecting the plates within the skull to allow them to grow together again properly. Because of the developmental implications and need for the sutures to reform, it is best to have surgery to repair Craniosynostosis before a child reaches 1 year of age. Dr. Burstein may perform the repair in conjunction with a Pediatric Neurosurgeon depending on the amount and location of fused sutures. Dr. Burstein uses his reconstruction skill to repair the following types of Craniosynostosis:

Coronal synostosis Coronal Synostosis, or Plagiocephaly, is the improper or untimely fusion of the suture that runs across the skull from ear to ear (Coronal Suture). It is exhibited by prominence of brow and/or forehead on one side of the head in which the eye is often a different shape from the one opposite.

Scaphocephaly Caused by the premature fusion of the suture that runs the length of the middle of the skull (Sagittal Suture), Scaphocephaly side effects include an elongated skull in which the length from front to back is greater than the width from side to side.

 

Trigonocephaly Evidenced by a triangular shaped/ pointed forehead in which the eyes are placed close together, Trigonocephaly is a fusion of the metopic (forehead) suture.

Surgery of the Jaw & Teeth / Malocclusion

Malocclusion is a condition marked by misalignment of teeth and is commonly referred to as cross bite, under bite, or over bite depending on the individual patient. While this is a very common problem seen in a majority of people and can usually be easily treated with braces, severe cases of malocclusion will require surgical jaw realignment by a maxillofacial surgeon.

Surgery of the Nose / Cleft Nasal Reconstruction & Deviated Septum

Whether the nose is distorted from a congenital birth defect or from facial trauma, Dr. Burstein utilizes a variety of specialized techniques to reconstruct the look and function of the nose. Patients suffering from a cleft lip can also experience a bilateral or unilateral deformity in the nasal passage – making breathing more difficult. Depending on the severity of the abnormality and the amount of scar tissue resulting from the correction of the cleft lip, Dr. Burstein will work to reshape the nasal cavity.

Another common nasal abnormality is a deviated septum, or a condition where the septum (the hard wall running down the middle of the nose, which cuts the nasal passages in half) is off-center. Deviated septums can be a result of trauma and can cause breathing/ congestion problems in a patient. Surgical reconstruction is recommended to correct this deviation.

Nasal abnormalities can also occur as a result of trauma or diseases like skin cancer. Severe cases of rosacea can lead to the development of rhinophyma, a rare condition marked by an enlarged red nose that may cause airway obstruction. Rhinophyma suffers often seek reconstructive surgery of the nose to restore function as well as appearance. Depending on the individual patient, Dr. Burstein utilizes the latest reconstructive techniques to restore the function and improve the appearance of the nasal abnormality.

Dr. Burstein has published numerous articles, detailing specific surgical techniques and nasal abnormality treatment information. Click here to access research articles authored by Dr. Burstein containing more specific and technical information about Surgery of the Nose.

Surgery for Cleft Lip & Palate

Surgery of the cleft lip or palate is normally performed on children of a very young age to correct the problem before the child reaches “school age.” Patients who are born with a cleft lift or palate, may have trouble speaking and eating properly, may also have missing teeth, misalignment of jaws and teeth, and nasal deformities. All of these conditions will be addressed during reconstruction to restore full function and appearance of the face. Patients often require more than one surgery to close the cleft or gap, restore full function, and improve appearance. Each surgery takes about from 2 to 3 hours with a 3 day recovery period on average.

Dr. Burstein also performs revision surgery for patients who have had their cleft lips and palates corrected at another practice (or as a child), but are still not happy with their physical appearance after their surgery.

Committed to improving the function and appearance of children born with cleft lips and palates, Dr. Burstein serves of the board of The Save-A-Smile Foundation (SASF). SASF is a non-profit organization dedicated to helping children with cleft lip and/or cleft palate; cranial defects.

Reconstructive surgery of the lip can also correct aesthetic problems due to trauma, disease, or infection.

As a specialist in craniofacial reconstruction, Dr. Burstein has authored many articles detailing specific surgical techniques, treatments, and ground-breaking research. Click here to access research articles authored by Dr. Burstein containing more specific and technical information about Surgery of the Head & Neck.

Surgery for Cleft Lip & Palate in Adults

While most patients undergo cleft lip and palate surgery as a child, adults may also opt to undergo this surgery. Adult cleft lip and palate patients may have long standing concerns about their appearance and the function of their lip/palate. These areas may have not been addressed in childhood or adolescence for any number of reasons. The alignment of the jaws and teeth, missing teeth, speech problems, nasal appearance, and function as well as lip aesthetics can be addressed during the surgical procedure. Modern techniques make correction of late cleft deformities a realistic goal with enhanced appearance and function.

Surgery of the Jaw/ Mandibular & Maxillary Reconstruction

Abnormalities of the jaw can be a result of congenital defects, trauma, or the result of a disease or infection where a section of the jaw area must be removed. Some types of congenital defects affecting the jaw include protrusion or recession of the upper and/or lower jaw. Dr. Burstein uses a variety of techniques including bone reduction and reshaping, facial implants, and repositioning of the jaw to correct these various deformities.

Click here to access research articles authored by Dr. Burstein containing more specific and technical information about Surgery of the Jaw.

Surgery of the Chin / Reconstructive Genioplasty

A patient suffering from abnormalities of the chin falls into one of two categories: an unusually small chin (also known as mirognathia) or an unusually large chin (also known as macrognathia). Depending on the patient, Dr. Burstein can work to surgically reshape or rebuild the chin to restore a more normal appearance. For some patients a procedure known as osseous genioplasty, or the replacement of a patients chin to be more forward, may be recommended. Treatments to rebuild the chin may require a facial implant and treatment to minimize the chin may require bone reduction. Dr. Burstein also operates on patients who have a chin deformity due to trauma or disease.

Torticollis

Also known as “wry neck”, torticollis is a congenital disorder induced by birth trauma or in-utero malposition that causes the involuntary contraction of the sternocleidomastoid, or neck muscles. The condition results in an inability to redirect the head straight to the front. Physical effects of torticollis include craniofacial asymmetry and very limited range of motion from the neck and head.

Dr. Burstein treats torticollis using a minimally invasive, endoscopic technique to release scar tissue in the affected neck muscles. With this technique, the risk of post-operative complications is decreased and scars are hidden in the hairline and behind the ear.

torticollis patient before surgery after torticollis surgery
torticollis patient before reconstructive surgery after reconstructive surgery for torticollis

Surgery of the Ears / Otoplasty

Due to the 3-dimensional shape of the ear and the fact that you cannot look at one ear while you operate on another, ear reconstruction can be a very complex surgery and should only be entrusted to a surgeon with a wealth of experience.

One common congenital defect of the ear is referred to as prominent ears, and like the name indicates, is a condition where ears appear to be sticking out from the head, making it difficult to wear glasses or hearing aids. Most patients with prominent ears are missing a bend of the ear, causing the entire ear to protrude. During otoplasty, patient’s ears are reconstructed to properly bend and are places closer to the head.

Ear reconstruction can also be used to correct a condition known as constricted ear, also known as “cup ear” or “lop ear”. Patients with constriction have abnormally short ears, which can vary in severity.

Another defect, known as microtia is a condition in which a person is missing most of their external ear. It is often associated with hemifacial microsomia or abnormal growth of the lower jaw and upper jaw area. Dr. Burstein will often use a patient’s own cartilage (from their ribs) to reconstruct the ear. In some cases, a prosthetic will be used. In any case, restoring appearance of the ear while maintaining full function is the ultimate goal.

Depending on the size and location of the defect of the ear, Dr. Burstein will utilize rebuilding techniques such as flaps, grafts, and primary linear closures. With the usage of modern technology, Dr. Burstein can restore the shape, size, and alignment of the ear.

Click here to access research articles authored by Dr. Burstein containing more specific and technical information about Surgery of the Ears.

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