Classification and Treatment of Hemifacial Microsomia

On the basis of 37 surgically treated patients with hemifacial microsomia, an anatomical-surgical classification was developed which divides these patients into five categories to facilitate surgical planning and help standardize treatment. Treatment was founded on the cooperation of a large craniofacial team. Osteotomies of the jaws, construction of the TM joint with costochondral grafts, onlay bone grafts, and genioplasty were performed to improve facial form and function. Facial scars were avoided. After three-dimensional skeletal alignment, there was rarely a compelling need for subsequent soft tissue augmentation.