• Le Fort I osteotomy, sagittal split osteotomy of the mandible and jaw distraction
• Correction of the lower border of the mandible and chin (Triaca wing osteotomy)
• Also in conjunction with temporomandibular joint surgery
• Tissue- and nerve-sparing piezosurgery
• Modern 3D planning techniques (VSP, virtual surgical planning) and CAD/CAM technology

• Treatment of the underlying cause of obstructive sleep apnoea through corrective jaw osteotomy
• Also in combination with a mandibular advancement device
• Digital measurement of the upper airway

• Reconstruction of the lower and/or upper jaw using the patient’s own bone from the angle of the jaw or the iliac crest
• Targeted use of synthetic bone substitutes where appropriate
• Gentle treatment of jaw necrosis (dead bone), e.g. during bisphosphonate therapy or following radiotherapy

• Arthroscopy (minimally invasive temporomandibular joint examination, irrigation or lavage)
• Open joint-preserving surgery
• Disc repositioning surgery (e.g. using the Mitek anchor technique)
• Joint reconstruction using modern patient-specific joint replacements
• Modern 3D planning techniques (VSP, virtual surgical planning) and CAD/CAM technology

• Septorhinoplasty (functional and aesthetic nasal surgery)
• Anthelixplasty (cartilage-preserving correction of the outer ear)

• State-of-the-art histological margin assessment following the surgical removal of benign and malignant facial skin tumours
• Functional and aesthetic reconstruction of all areas of the face (eyebrow, eyelid, cheek, nose, ear and lip)
• Correction of tissue deficits, including with the patient’s own fat

Skin conditions caused by ultraviolet light become more common with age. Because the face is exposed to particularly high levels of sunlight, it is often affected.

Alongside premature skin ageing, typical consequences of UV exposure include skin tumours. These range from precancerous changes and naevi, meaning pigmented marks or moles, to squamous cell carcinoma, basal cell carcinoma and malignant melanoma.

Simple pigmented marks such as naevi or moles are generally harmless. However, any change in colour, size or pigmentation should always be assessed histologically.

In addition to safely removing the skin lesion, particular attention is paid to functional and aesthetic reconstruction of important facial structures such as the eyelids, eyebrows, nose, ears and lips.

To achieve the least conspicuous scarring possible while preserving good function, incisions follow the relaxed skin tension lines and the aesthetic units of the face.

Skin conditions are always treated in close consultation and cooperation with the patient’s dermatologist.

The approach to malignant skin lesions is agreed by an interdisciplinary skin tumour board.

Conditions treated

• Facial scars, for example following accidents or previous surgery
• Facial pigmentation disorders, including congenital changes such as cosmetically troublesome moles or naevi
• Skin tumours of the face and neck, including non-melanoma and melanoma skin cancer

Jaw deformities have many causes, are often congenital and frequently cause functional as well as aesthetic impairment. Pathological changes in the jaw joints are also a common cause.

Healthy chewing and speech require the upper and lower teeth to meet correctly. Straightforward tooth misalignment can be corrected with orthodontic treatment using removable or fixed braces.

When the positions of the upper and lower jaw differ substantially, however, a functional bite can often be achieved only with surgery. This can frequently also create a more harmonious facial profile.

An individual treatment plan is developed in close consultation with the treating orthodontist using state-of-the-art digital 3D planning.

Conditions treated

• Facial asymmetry or a visibly uneven face
• Jaw deformity (dysgnathia)
• Malocclusion

A visibly unusual nasal shape can have many different causes. It is often congenital and usually simply a normal variation; occasionally it is the result of an accident, such as a traumatic crooked nose. However, it is also frequently associated with substantial impairment of nasal function.

Misalignment of the upper jaw and midface, such as maxillary hypoplasia or midface hypoplasia, can also adversely affect the shape, function and projection of the nose.

This is often accompanied by narrowing at the entrance to the nose, known as the nasal valve, which can also obstruct nasal breathing.

An assessment by an ear, nose and throat specialist should always be carried out before planned functional and aesthetic nasal surgery.

Malformations of the outer ear, such as prominent ears, can be aesthetically distressing and can be corrected surgically using cartilage-preserving techniques.

Conditions treated

• Nasal deformity with impaired function, such as a crooked nose or nasal hump
• Deformity of the outer ear, such as prominent ears

A variety of causes can lead to loss of bone in the jaw. Tooth loss over a prolonged period commonly causes this type of jaw atrophy, which in turn makes artificial tooth replacement more difficult.

Modern medicines that have a positive effect on bone metabolism, such as bisphosphonates, are used very successfully to treat osteoporosis or bone metastases. However, medication-related osteonecrosis of the jaw is a recognised potential side effect.

A similar condition, known as osteoradionecrosis, can occur after radiotherapy for malignant tumours in the head and neck region.

Our aim is to reconstruct the affected parts of the jaw using the patient’s own bone or high-quality bone substitutes and, where needed, make high-quality dental restoration possible.

Conditions affecting the facial skeleton, oral mucosa and salivary glands are diagnosed according to the latest standards and treated appropriately.

Conditions treated

• Chronic inflammation and necrosis of the jaw, for example as a side effect of bisphosphonate treatment or following radiotherapy
• Atrophy of the upper and lower jaw, meaning age-related bone loss
• Bone lesions, including cysts and tumours
• Consequences of accidents
• Diseases of the oral mucosa
• Diseases of the salivary glands

Symptoms around the temporomandibular joint can have many different causes. The teeth, through the bite or occlusion, the chewing muscles and the two jaw joints form one functional unit whose balance is essential in this highly sensitive region. A disorder affecting any one of these structures can cause a complex pattern of symptoms throughout the functional unit. This is broadly described as temporomandibular disorder (TMD).

Clinical structural and functional analysis aims to identify the anatomical structure primarily affected and therefore the true source of pain. Grinding the teeth at night, for example, often causes muscle pain similar to soreness after exercise, which may lead to pain in the jaw joints months or years later. Conversely, painful rheumatic disease in a jaw joint can cause a painful reaction in the chewing muscles, creating a “chicken and egg” problem.

Uniquely in the human body, the two jaw joints can function only together. Pathological changes on one side therefore usually affect the other side as well. Another special feature is the jaw joint’s exceptionally wide range of movement, making it one of the body’s most mobile joints. This also makes it particularly susceptible to problems. Because the joint capsule is especially wide towards the front and centre, displacement of the articular disc in these directions is very common.

Very rare causes of symptoms in this area must also be ruled out during diagnosis, including tumours and congenital differences.

Even in advanced cases where the joint can no longer be preserved and complete replacement is required, modern patient-specific joint replacements provide a reliable treatment option. This may be considered, for example, where the joint has fused (ankylosis) or the condylar head is being resorbed.

Conditions treated

• Overactivity of the chewing muscles, causing muscle soreness
• Disc disorders, including displacement of the articular disc with clicking in the joint
• Osteoarthritis of the temporomandibular joint, with grinding or rubbing in the joint
• Chronic inflammatory diseases of the jaw joint, such as rheumatic disease
• Resorption of the jaw joint, with or without changes to the bite
• Ankylosis of the jaw joint, causing joint fusion and reduced mouth opening
• Congenital differences of the jaw joint
• Benign and malignant growths of the jaw joint

Sleep-related breathing disorders can have serious health consequences and are often diagnosed only at a late stage.

When the base of the tongue relaxes during sleep, a disorder can prevent enough air from passing through the throat, often causing snoring. The body does not receive enough oxygen. Patients typically report daytime tiredness and reduced performance. If left untreated, obstructive sleep apnoea syndrome (OSAS) often leads to chronic conditions such as high blood pressure and heart disease.

OSAS can also be caused by a receding lower jaw, which anatomically pushes the base of the tongue backwards.

A mandibular advancement device can be used to test whether moving the lower jaw forwards has a positive effect and, where appropriate, determine how much advancement is required.

Corrective osteotomy with advancement of the jaw, often involving the upper and lower jaw together, can then treat the underlying cause.

Condition

• Breathing disorder during sleep caused by relaxation and narrowing around the tongue and throat
• Significant risk of cardiovascular complications