I finished my craniofacial clinical fellowship and returned to Taiwan at the end of June, 1080. It has been over 41 years since I started my practice as a craniofacial plastic surgeon. During my plastic surgery resident and fellowship training, I have learned surgical anatomy, physiology of wound healing, bone graft “taken” mechanism, as well as surgical technique of dissection, bone cutting and fixation. All of these training focused on pursuing the patient’s recovery to a “normal” face (還我本色) without visible scar or stigmata of facial deformities.
Facial trauma with or without facial bone fracture were the most common patients I have encountered in the first decade of my practice (1980-1990). Early reduction and rigid fixation of fractured bone with proper periosteum and soft tissue repair always achieve good results. I passed the facial trauma patients to Dr. CT Chen, after he finished his resident training in 1993. Congenital craniofacial anomalies including cleft lip/palate, rare facial clefts, craniofacial syndromes were among the common operation schedule during my first two decades of practice. I did my last primary complete cleft lip/palate patient (楊梓旻) in 1996. He is 25 y/o now, with normal speech, occlusion and look, he only had three operations: cheiloplasty, palatoplasty and alveolar bone graft. I passed the intracranial craniofacial surgery and primary clefts to Drs. KT Chen and LJ Lo after they finished their craniofacial fellowship in Toronto and St. Louis.
Craniofacial Fibrous Dysplasia is not common, but is my favorite and specialized craniofacial category. I found complete removal of the diseased bone with primary rib/calvaria/iliac bone graft can cure the disease, but not all the patients could be completely resected because of the location of the diseased area. Vision loss caused by the expansion or cystic degeneration of the diseased bone happened in orbito-sphenoid fibrous dysplasia. US NIH invited me in 2010, joined with other specialists to set up a treatment guideline which was published in 2012.
Orthognathic surgery(OGS) is the most powerful surgical procedure to change the facial midline, symmetry, proportion and profile. OGS is the most frequent surgery I am doing now, it can change the deformed face to a normal, attractive one, also can improve the airway, occlusion, articulation and self-confidence. We developed the “surgery-first approach OGS” to challenge the traditional “orthodontic-first approach OGS” and echoed from numerous centers in the world.

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