Facial Plastic & Reconstructive Surgery

Our areas of expertise in facial plastic and reconstructive surgery

We offer a wide range of procedures to rebuild areas of your head, neck and face that have been affected by cancer treatment, trauma or congenital conditions (present at birth). Our goal is to improve your appearance while maximizing your abilities to breathe, speak and eat. Our reputation for delivering excellent outcomes draws patients from across the country.

Microvascular facial reconstruction

All of our surgeons have advanced fellowship training in microvascular surgery, a specialized approach to transferring tissue flaps from another part of your body to help repair larger areas of damage on your face. Once the tissue is transferred, our surgeons carefully reconnect blood vessels and nerves using a microscope.

Benefits of microvascular reconstruction include:

• Better healing

• Improved function

• Superior aesthetic results

Skin color matching in head and neck reconstructive surgery

Surgeons at UCSF Health pioneered a new technique to more accurately match the color of transferred skin flaps to the color of facial skin. For example, skin flaps from the thigh, calf or arm are often lighter than sun-exposed facial skin, which can create an undesirable white patch on the face. In these cases, we can remove the top layers of skin from the flap and place a thin, nearly transparent skin graft over it that allows more natural pigment (skin color) to show through.

Reanimation surgery for facial paralysis

For people who have facial paralysis from Bell's palsy or other facial nerve disorders, reanimation surgery can help restore their ability to make facial expressions and improve facial symmetry.

During the procedure, we connect the healthy nerve used for chewing to the paralyzed facial nerve used for smiling. In some cases, we also transfer muscle tissue and blood vessels from the side of your torso (flank) or thigh to your face.

Our multispecialty team, including neurotologists, otologists, oculoplastic surgeons, neurosurgeons and physical therapists, works together to help you achieve the best possible results from facial reanimation surgery.

Mohs reconstruction

Mohs micrographic surgery is a treatment for skin cancer. During the procedure, dermatologic surgeons remove thin layers of skin, one layer at a time, and examine them under a microscope. They continue removing layers until no signs of cancer remain.

After Mohs surgery, some people may have a significant area of skin on their face that needs to be repaired. Our facial plastic surgeons use skin grafts or flaps to perform complex skin reconstructions on the cheeks, lips, ears and nose.

Complex nasal reconstruction

We specialize in nasal reconstruction procedures that rebuild the nose's structure and improve its functioning, such as breathing or smelling ability, which can be affected by major surgery or trauma.

Depending on your needs, your surgeon will use cartilage or skin flaps from another area of your face or body to reconstruct the inner and outer parts of your nose. Our surgical team's breadth of expertise in otolaryngology, head and neck surgery and reconstructive surgery makes them uniquely qualified to perform these complex procedures.

Gender-affirming surgery for the face and neck

Our surgeons are leaders in gender-affirming surgery of the face, also called facial feminization or facial masculinization.

They have developed several new techniques that are now used worldwide, including minimally invasive techniques to feminize the appearance of the jaw and neck.

In fact, we pioneered the scarless tracheal shave, a procedure that minimizes the appearance of the Adam's apple (thyroid cartilage) in transgender women seeking a more feminine look. Our surgeons access this cartilage through the mouth during jaw reduction surgery, so there are no visible incisions on the front of the neck.

At UCSF Health, the same elite team of surgeons that performs complex reconstructive surgeries also specializes in surgical and nonsurgical cosmetic procedures. Our extensive capabilities mean we can offer the right procedure to meet your needs.

We also use the latest technology to plan your procedure, creating virtual 2D or 3D photographic models before surgery that allow you to preview the results. This approach helps us ensure we meet your aesthetic goals.

We offer cosmetic procedures that address:

• Age-related spots or skin changes

• Drooping eyelids or eyebrows

• Facial aging

• Facial asymmetry

• Nasal asymmetry or deformity

• Recessed chin (small or short chin)

• Sagging skin and lost volume (fullness)

• Scars

• Wrinkles

Facial rejuvenation surgery

Aging, sun damage, weight loss and many other factors can affect the elasticity of your skin. Our surgeons specialize in a range of procedures to help tighten loose skin, reduce the appearance of wrinkles and add volume to your face. We offer:

• Brow lifts

• Cheek enhancement procedures

• Eyelid surgeries

• Facelifts, including deep plane facelifts

• Facial fat grafting

• Neck lifts

A rhinoplasty, or nose job, is a procedure to reshape or resize your nose to improve facial symmetry. A septoplasty can correct a deviated septum (misaligned cartilage and bone between your nasal passages) and improve breathing issues.

At UCSF Health, our surgeons offer both endonasal (closed) and open rhinoplasty and septoplasty procedures. Open surgery, which involves an incision between your nostrils, may be right for people who want to significantly change the appearance of their nose or have complex nasal problems.

A closed procedure, which is performed entirely through your nostrils with no visible scars, is appropriate for some patients and usually offers shorter recovery time. We also offer combined rhinoplasty and septoplasty procedures that can address both cosmetic and functional concerns.

Nonsurgical facial rejuvenation is ideal for people who want to improve the look and feel of their skin with minimal downtime and quick results. We can perform many of these aesthetic procedures right in our office.

We offer a full range of nonsurgical cosmetic treatments, including:

• Chemical peels

• Injectable fillers

• Laser skin resurfacing

• Neuromodulators, such as Botox