Here is the second in a series of Q & A answered by Mr Adel Fattah, Consultant Paediatric Plastic and Microsurgeon at Alder Hey Hospital.
The best age to have surgery really depends on what you mean by ‘best’. From a surgeon’s perspective, the best age is when a child is big enough to make the surgery technically feasible and old enough to be compliant with the post-operative course and exercises. However, my personal philosophy is to wait until the child is old enough to understand their condition, to realize that their smile is different from other children and want to do something about it. Then a long conversation ensues with multiple consultations whereby the options for surgery are carefully explained along with what to expect and what will and can happen. If necessary, appointments are made with other members of our multidisciplinary team, eg. psychology. Once I am satisfied that the child and family fully understand then I will agree to surgery, this is usually around the age of 7-10 years at the earliest. Adult patients are different, assuming they are fully informed, reanimation surgery tends to depend on the age of the patient. After the third and fourth decades of life, nerve growth is less exuberant and the results of facial reanimation surgery can be less effective. Nonetheless, this is an individual decision and there are no hard and fast rules that dictate which age is best for reanimation surgery.
If this article was of interest take a look at the first article in this series here.
Adel is a consultant at the Alder Hey Children’s NHS Foundation Trust whose primary specialty is facial palsy reconstruction. He trained at Great Ormond Street Hospital and the Hospital for Sick Children, Toronto with Dr Ron Zuker. He has established a multidisciplinary team that provides holistic care for all aspects of facial palsy in children.