Joseph Kerwin Williams, M.D.
- Board Certified in Plastic & Reconstructive Surgery
- Chief of Plastic Surgery at Children’s Healthcare of Atlanta at Scottish Rite
- Director of Research at the Center for Craniofacial Deformities
- Associate Professor at Emory University in the Division of Plastic Surgery
Located at our Northside Location
Reconstructive Plastic Surgery
Reconstructive surgery is a specialized form of plastic surgery that is designed to restore proper function while correcting defects and abnormalities of the face and body. A board certified plastic and reconstructive surgeon, Dr. Williams received specialized training at both New York University and Emory University in Atlanta, GA. For patients who have facial abnormalities, either due to trauma, disease, or craniofacial defects (such as cleft lip/palate), Dr. Joseph Williams utilizes the least invasive and most up-to-date surgical techniques to restore both functionality and appearance.
Click on a procedure listed below to read more:
- Maxillofacial surgery
- Facial abnormalities / Facial Abnormalities in Children
- Congenital Disorders
- Craniofacial Surgery
- Surgery for Craniosynostosis
- Surgery of the Jaw & Teeth / Malocclusion
- Surgery of the Nose / Cleft Nasal Reconstruction & Deviated Septum
- Surgery for Cleft Lip & Palate
- Surgery for Cleft Lip & Palate in Adults
- Surgery of the Jaw / Mandibular & Maxillary Reconstruction
- Surgery of the Chin / Reconstructive Genioplasty
- Surgery to Correct Torticollis
- Surgery of the Ears / Otoplasty
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 specializing in facial procedures, Dr. Williams has extensive experience performing reconstructive facial work. Dr. Williams currently serves as the chief of Plastic and Reconstructive Surgery at Children’s Healthcare of Atlanta, the Director of Research at the Center for Craniofacial Deformities, and is an associate professor for Plastic and Reconstructive Surgery at Emory University.
Facial Abnormalities / Facial Abnormalities in Children
Whether a child is born with a facial deformity or a deformity occurs later in life as the result of an accident, reconstructive surgery can address those areas of concern and help improve a patient’s quality of life. As the Chief of Plastic Surgery at Children’s Healthcare of Atlanta at Scottish Rite and Director of Research at the Center for Craniofacial Deformities, Dr. Williams specializes in reconstructive surgery of the face, and has a special interest in children’s reconstruction. Some of the common facial deformities that Dr. Williams has helped to treat 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). Often corrected through otoplasty.
- 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. It may be corrected through cosmetic or reconstructive chin surgery.
- 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.
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 is a specialty subset of maxillofacial surgery, targeting areas of the skull, jaw, and face affected by congenital abnormalities. As Chief of Plastic Surgery at Children’s Healthcare of Atlanta at Scottish Rite and Director of Research at the Center for Craniofacial Deformities, Dr. Williams uses the latest techniques for correction of abnormalities such as cleft lip, cleft palate, mandibular abnormality, and abnormalities of the skull.
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. Williams may perform the repair in conjunction with a Pediatric Neurosurgeon depending on the amount and location of fused sutures. Dr. Williams uses his experience in reconstructive plastic surgery to repair the following types of Craniosynostosis:
- 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 is 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 is 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. This relatively common problem can usually be easily treated with braces, but 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. Williams utilizes a variety of specialized rhinoplasty 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. Williams will work to reshape the nasal cavity.
Another common nasal abnormality is a deviated septum, 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. A deviated septum may be natural or the result of trauma, but in either case can potentially 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. Williams utilizes the latest reconstructive techniques to restore the function and improve the appearance of the nasal abnormality.
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 lip 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 cleft lip or cleft palate surgery takes about from 2 to 3 hours with a 3 day recovery period on average.
Dr. Williams also performs revision surgery for adult 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. Reconstructive surgery of the lip can also correct aesthetic problems due to trauma, disease, or infection.
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. Williams uses a variety of techniques including bone reduction and reshaping, facial implants, and repositioning of the jaw to correct these various deformities.
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. Williams 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. Williams also operates on patients who have a chin deformity due to trauma or disease.
Surgery to Correct 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. Williams treats torticollis using the most advanced surgical techniques to release scar tissue in the affected neck muscles. The advanced procedure carries a low risk of post-operative complications and keeps scarring to a minimum.
Surgery of the Ears / Otoplasty
Ear reconstruction, or otoplasty, attempts to restore the appearance of the ear while maintaining full function. Due to the three-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. Ear surgery can correct the appearance of ears that have been injured as a result of trauma, as well as those that suffer from congenital defects, such as:
- Prominent ears: 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.
- Constricted ear: also known as “cup ear” or “lop ear”, a constricted ear is abnormally short. The condition can vary in severity.
- Microtia: a condition in which a person is missing most of their external ear, microtia is often associated with hemifacial microsomia or abnormal growth of the lower jaw and upper jaw area. Dr. Williams will usually attempt to use a patient’s own cartilage (from their ribs) to reconstruct the ear, but in some cases a prosthetic will be used.
Depending on the size and location of the defect of the ear, Dr. Williams uses rebuilding techniques such as flaps, grafts, and primary linear closures. With these techniques and the most advanced technology, Dr. Williams can restore the shape, size, and alignment of the ear.