Craniofacial Microsomia (CFM)

About Craniofacial Microsomia (CFM)

Craniofacial microsomia is the second most common congenital facial difference after cleft lip and palate. It results from incomplete development of structures derived from the first and second branchial arches, leading to under-growth on one or both sides of the face. The ear may be small (microtia) or absent (anotia), the lower jaw shorter on the affected side, the cheek flatter and the soft tissues thinner. Severity varies widely, which is why every plan is individual.

Diagnosis at Kayakriti is clinical first, supported by imaging when needed. We document facial symmetry, ear development, jaw size, dental occlusion and hearing status. CT and 3D imaging map skeletal under-growth precisely, and we coordinate with ENT for hearing assessment and audiology, with paediatrics for general development and with orthodontics for the dental picture. Genetic counselling is offered where appropriate. The aim is a clear, staged roadmap rather than rushed surgery in early infancy.

Reconstructive facial surgery for CFM is delivered in stages timed to growth. Cleft lip components, when present, are repaired in the first year. Ear reconstruction using rib cartilage is typically planned around age eight, when the cartilage is large enough to harvest. Jaw deformity correction, depending on severity, may use distraction osteogenesis to gradually lengthen a short mandible, or single-stage orthognathic surgery once growth is complete. Soft tissue balance is restored later with grafts, fat transfer or microvascular flaps.

Pediatric craniofacial surgery is as much about families as it is about anatomy. We provide honest counselling about timelines, the number of operations expected and the realistic limits of correction. School scheduling, hearing support, speech therapy and dental procedures often run in parallel. Dr. Agarwal, FRCS Edinburgh, and our team explain each step in plain language, and welcome second opinions. Privacy is strictly maintained for every child and family who comes to us in Lucknow.

What to expect

• Multi-disciplinary assessment with paediatric, ENT, dental and surgical input
• Imaging including 3D CT to map skeletal under-growth precisely
• A staged treatment plan timed to growth milestones
• Cleft repair in the first year when applicable
• Ear reconstruction using rib cartilage typically around age 8
• Jaw correction with distraction or orthognathic surgery as needed
• Soft tissue balancing with grafts, fat transfer or microvascular flaps

Recovery

• Each surgical stage has its own short hospital stay and recovery
• Expect a guided diet, oral hygiene and wound care plan after every operation
• Speech therapy and audiology support continue between surgical stages
• Most children return to school within two to three weeks after major surgery
• Final facial balance matures over many years as growth completes
• Long-term follow-up reviews safeguard symmetry and function