Editorial
Reconstructive surgery: function versus aesthetics? Reconstructive oral and maxillofacial surgery has undergone major developments during the last 20 years. O M F surgeons have learned to perform osteotomies at almost all levels of the facial skeleton with predictable results which are generally both functionally satisfactory and aesthetically pleasing. It is only logical that, at first, the main concern was the functional aspect. Maxillofacial orthopaedic surgery endeavoured to restore occlusion and articulation. Over the years, however, more has been learned about the changes of the soft facial tissues when pieces of the facial skeleton are moved. At present, it is customary to consider facial balance in conjunction with restoration of occlusion when planning osteotomies. The aesthetic aspect has gained greater importance in the decision making. At the same time, technical advances have enabled adjunctive surgical procedures to be carried out simultaneously with the osteotomies to improve the aesthetic re-
sults. Liposuction and rhinoplasties are examples of these measures. The aesthetic and functional components of maxillofacial orthopaedic surgery have become equally important. On the other hand, soft tissue facial aesthetic surgery can no longer exist without a thorough knowledge of what is possible with maxillofacial orthopaedic surgery. It is long since alloplastic material was used to augment deficient parts of the facial skeleton to camouflage genuine skeletal abnormalities. The coordinated approach by orthodontists and O M F surgeons has almost completely replaced these masking procedures. It is equally unacceptable to fill defects in the oro-facial region with bulky soft tissue grafts and ignore the functional aspect. For instance, the use of modern endosseous implants has made it possible to insert implants in bone grafts, enabling patients to assume normal chewing function. Defects are no longer masked by using a variety
flaps. The current trend is to augment these techniques for restoring function by using bonegrafts and implant devices. The old adagium "function versus aesthetics", simply does not exist any more. Current knowledge of bone and soft tissue grafts provides plenty of alternatives for coping with most of the problems in oral and maxillofacial reconstructive surgery. O M F surgeous are required almost daily to decide on the best possible treatment for their patients, taking into account both the functional and aesthetic aspects; in reconstructive surgery this can be done simultaneously. This journal will try to select manuscripts that cover both aspects adequately, thereby assisting our readers to make the proper choices. For that reason we have added the word "Aesthetic" to the heading of Section I.
PAUL J. W. STOELINGA
Reconstructive surgery: function versus aesthetics? Reconstructive oral and maxillofacial surgery has undergone major developments during the last 20 years. O M F surgeons have learned to perform osteotomies at almost all levels of the facial skeleton with predictable results which are generally both functionally satisfactory and aesthetically pleasing. It is only logical that, at first, the main concern was the functional aspect. Maxillofacial orthopaedic surgery endeavoured to restore occlusion and articulation. Over the years, however, more has been learned about the changes of the soft facial tissues when pieces of the facial skeleton are moved. At present, it is customary to consider facial balance in conjunction with restoration of occlusion when planning osteotomies. The aesthetic aspect has gained greater importance in the decision making. At the same time, technical advances have enabled adjunctive surgical procedures to be carried out simultaneously with the osteotomies to improve the aesthetic re-
sults. Liposuction and rhinoplasties are examples of these measures. The aesthetic and functional components of maxillofacial orthopaedic surgery have become equally important. On the other hand, soft tissue facial aesthetic surgery can no longer exist without a thorough knowledge of what is possible with maxillofacial orthopaedic surgery. It is long since alloplastic material was used to augment deficient parts of the facial skeleton to camouflage genuine skeletal abnormalities. The coordinated approach by orthodontists and O M F surgeons has almost completely replaced these masking procedures. It is equally unacceptable to fill defects in the oro-facial region with bulky soft tissue grafts and ignore the functional aspect. For instance, the use of modern endosseous implants has made it possible to insert implants in bone grafts, enabling patients to assume normal chewing function. Defects are no longer masked by using a variety
flaps. The current trend is to augment these techniques for restoring function by using bonegrafts and implant devices. The old adagium "function versus aesthetics", simply does not exist any more. Current knowledge of bone and soft tissue grafts provides plenty of alternatives for coping with most of the problems in oral and maxillofacial reconstructive surgery. O M F surgeous are required almost daily to decide on the best possible treatment for their patients, taking into account both the functional and aesthetic aspects; in reconstructive surgery this can be done simultaneously. This journal will try to select manuscripts that cover both aspects adequately, thereby assisting our readers to make the proper choices. For that reason we have added the word "Aesthetic" to the heading of Section I.
PAUL J. W. STOELINGA
