Breast reconstruction following the traumatic experience of breast removal (mastectomy) due to cancer or similarly threatening disease is one of today's most rewarding plastic surgery applications.

Approximately one out of every 750 babies is born with a cleft lip, a condition in which the lips fail to form properly during embryonic development. The reason is usually unknown, but the condition occurs during the first trimester, and the probability is much higher in families with a history of clefts.

Because each cleft is unique in its appearance and severity, each cleft lip repair is different. Two steps are usually involved. First is the placement of a small plate or prosthesis that covers the roof of the mouth or palate. The prosthesis is attached to two small elastic molds that are used to form the edges of the cleft into a more normal position. This facilitates the second step, which is the surgical repair that occurs at about eight to ten weeks of age.

Cleft lip surgical procedures are performed in the hospital using general anesthesia and require a short stay during recovery, usually one to two days.

A cleft palate occurs when the embryonic components of the roof of the mouth fail to fully form. The condition occurs in many variations. The cleft may involve just the soft palate, or the hard palate, or both. It may be on one side of the mouth, or on both. The gum line where the teeth emerge may or may not be involved.

Because cleft palates vary greatly from child to child, the surgical repair also varies. Similar to cleft lip repair, the procedure requires multiple steps. The first entails the closure of the soft palate, which is performed at about ten to twelve months of age. The surgery closes the cleft, lengthens the palate and reorients the muscles. Sometimes, children will have a prosthesis placed over the hard palate cleft until the age of three to four years, at which time the hard palate will be repaired.

If necessary, further surgery will be needed to repair a cleft of the gum line when the child is approximately six years of age. Cleft palate surgical procedures are performed in the hospital using general anesthesia, and they require a short stay during recovery, usually one to two days.

Craniosynostosis is a general term that describes a variety of developmental problems in which the skull is unable to form normally and accommodate the growing brain. The definite cause of these disorders is not clear. Typically, one or more of the growth centers of the skull or cranium close prematurely, which results in a deformed skull.

The difference between craniosynostosis and skull-shape abnormalities that result from "positional molding" must be recognized. Abnormalities resulting from positional molding affect the soft skull bones of an infant. These bones can be molded by persistent pressure in one area, such as if the infant lies primarily on one side. That one side will slowly develop a "flat spot" and there will be a compensatory bulge, usually on the opposite side of the skull. Positional molding needs to be recognized early because it can be treated by turning the infant off the flat side to the opposite side, or in some cases by using a molding helmet to direct the growth of the skull. This is typically not a surgical problem and occurs much more often than craniosynostosis, which is a surgical problem.

Because each occurrence of craniosynostosis is unique, the best treatment approach is also unique. The condition is usually treated by a team of neurosurgeons and plastic surgeons specially trained in craniofacial surgery. The operation involves removing the malformed bones and repositioning or reforming them and then replacing them to create a more appropriately shaped skull.