What is craniofacial surgery?

Craniofacial surgery treats conditions that affect the bones and soft tissues of the head and face. This small area of your child’s body is very complex. It affects how your child sees, hears, breathes, chews, swallows, interacts with other people — and even how their brain grows.

For best possible results, children with craniofacial conditions need to receive the right surgery at the right time from an experienced team. Seattle Children’s Craniofacial Center provides the highest level of craniofacial surgical care.

What types of craniofacial surgery are done at Seattle Children’s?

Our craniofacial surgeons perform all types of craniofacial surgery. The most common surgeries are for cleft lip and palate and craniosynostosis. Our surgeons also skillfully adjust the midface and jaws of children with complex syndromes.

  • We repair more cleft lips and palates than any other center in our 4-state region (Washington, Alaska, Montana and Idaho). Children come here from around the world to be treated. To reduce the surgery your child may need, we use nasoalveolar molding (NAM) to make the cleft smaller before surgery.

  • We are a leader in open surgery for craniosynostosis and in less invasive endoscopic strip craniectomy. Our team has more combined experience treating craniosynostosis than any other center in the United States. Our program is the largest in our 4-state region.

  • Our team is experienced in reshaping the skull, midface and jaw to treat children with:

    • Syndromes related to craniosynostosis, including Apert syndrome, Crouzon syndrome, Muenke syndrome, Pfeiffer syndrome and Saethre-Chotzen syndrome
    • Conditions linked to cleft palate such as Van der Woude syndrome, Stickler syndrome, Robin sequence and 22q11.2-related disorders
    • Jaw and ear malformations, like craniofacial microsomia and Treacher Collins syndrome

    Our approach helps children get the most benefit from surgeries early in childhood. As a result, later in life, some surgeries are either not needed or are less extensive. Our work to refine surgery for children with Apert, Pfeiffer and Treacher Collins syndromes is changing the practice of surgeons around the world.

    See details of the procedures we perform.

  • For many conditions, we combine surgery with distraction osteogenesis. Using a distractor device after surgery helps a child’s body grow new bone. This lets us make bigger corrections in bone position than surgery alone.

  • Children with limited facial movement because of a problem with the facial nerve may need facial reanimation. We offer a range of procedures.

    Read how “smile surgery” helped Christian, a boy with a paralyzed face.

  • Our craniofacial surgeons do many surgeries for less common conditions, including:

    • Conditions that affect multiple parts of the head, face and neck, like encephalocele, frontonasal dysplasia and facial clefting
    • Head or face trauma, like broken bones from an accident or damage from a severe infection
    • Conditions that require urgent surgery in a newborn, like mandible distraction surgery for a baby with Robin sequence
    • Conditions so rare that our surgeons must design surgery for a single child because there is no established treatment

    Read about the conditions we treat.

  • We welcome children who had craniofacial surgery at another hospital and want to change surgeons or want a second opinion about the best treatment for them. Each year we work with many families to plan and perform surgery to improve the results of care they received at another hospital.

    Call the Craniofacial Center at 206-987-2208 for more information.

Why choose Seattle Children’s for craniofacial surgery?

Seattle Children’s has a national and international reputation for excellence in craniofacial surgery.

Every year, we treat hundreds of children with conditions from common clefts to rare syndromes. No matter how complex, we have likely taken care of someone with your child’s condition.

See Statistics and Outcomes for details on the children we care for and procedures we perform.

  • We bring experts from many fields together in one place to care for your child ⎼ 50 members from 19 specialties.

    Before, during and after surgery, your child’s craniofacial surgeon works closely with craniofacial pediatricians, craniofacial nurse practitioners and many others to meet your child’s needs:

    • Planning and performing the surgery that is best for your child
    • Carefully coordinating care so you do not have to go from office to office
    • Communicating with each other and with you about your child’s treatment

    We listen to your preferences and concerns, answer your questions, set treatment goals together with you and explain what to expect from surgery.

    After surgery, the craniofacial team partners with other Seattle Children’s staff to care for your child. These include nurses and intensivists who have special training in caring for craniofacial patients.

  • 3-D CT (computed tomography) scans and advanced software allow us to capture and analyze detailed images of your child’s skull and face.

    We use 3-D imaging technology to:

    • Predict your child’s future growth and plan for the desired position of bones at adulthood.
    • Plan the exact steps in complex surgeries and guide the surgeon during your child’s surgery.
    • Build a physical model of your child’s skull using a 3-D printer.
    • Measure your child’s results after surgery. This helps us improve techniques and invent new ones.

    If an imaging method uses radiation, we use the lowest dose possible.

  • Each member of your child’s craniofacial surgery team is dedicated to providing the highest level of care and to finding new ways to improve surgery results.

    We are the only craniofacial team in Washington state recognized by the American Cleft Palate Craniofacial Association (ACPCA). This shows we meet ACPCA’s quality care standards in 6 categories.

    To guide treatment from diagnosis onward, our team created clinical care pathways for craniosynostosis and for cleft lip and palate. These guide doctors to give the best care and make it easier to improve that care.

  • Seattle Children’s is training the next generation on advanced procedures and well-coordinated care for children who need craniofacial surgery. We are the only teaching hospital that offers pediatric fellowships in Craniofacial Plastic Surgery, Craniofacial Pediatrics and Craniofacial Surgical Orthodontics.

    Since we started Partners in African Cleft Training (PACT) in 2007, more than 90 African healthcare providers have been trained to treat cleft lip and palate. They treat children in their own clinics and train other providers in their countries. PACT was co-founded by Dr. Richard Hopper, surgical director of the Craniofacial Center, and the center’s medical director, Dr. Michael Cunningham.

    Learn more in our blog post and video.

Who is on the craniofacial surgery team?

After training as plastic surgeons, our craniofacial surgeons take extra training (a fellowship) in skull and facial surgery. This prepares them to perform the complex procedures your child may need on their skull and face.

Based on your child’s needs, your craniofacial surgeon may work with other experts to plan and perform your child’s surgery. They may include:

Pediatric anesthesiologists, who have special training in giving anesthesia to children, will ensure your child’s safety and comfort during surgery.

We have full-time nurse practitioners trained for craniofacial surgery, plastic surgery and oral surgery. They:

  • Care for your child in the clinic and hospital
  • Coordinate your child’s care
  • Ensure we meet your child’s needs
  • Teach your child and family about your child’s condition and treatment

One of our craniofacial social workers will meet with your family to talk about your wishes, concerns, questions and needs. Their main role is to be your advocate.

Many other members of the craniofacial team may play a part in your child’s care. Meet the craniofacial team.

Contact Us

Call the Craniofacial Center at 206-987-2208 for more information, a second opinion or to make an appointment. See other ways to contact us.

To make a referral, please see how to refer a patient.