CRANIOFACIAL SURGERY

Jonathan is internationally known for his work in aesthetic and reconstructive craniofacial surgery. He is a leading voice in the field and has contributed much through academic and published work.

The speciality of craniofacial surgery uses operative techniques which cross from the skull and into the face and are used to correct major developmental syndromes of the head and face such as Crouzon Syndrome, Treacher Collins Syndrome, craniofacial cancers and Plagiocephaly.

Specialist craniofacial techniques often form part of larger integrated programmes of care from birth to maturity. This broad approach has given Jonathan a deep understanding of the long-term, life-enhancing impact of surgery and has rewarded him with many lasting relationships with patients and families – a privileged combination of the highly technical, with the highly personal relationships of family general practice.

It was a tremendous pleasure to read your letter received in my private office this week. Such a lovely start to the New Year, and I thank you for taking the time to commit your thoughts to a letter. I shared your letter with my wife, also a paediatric doctor (anaesthetist) as a reminder to us both of the privilege we share in childrens’ medicine and surgery. I am delighted that A~~~~ has had a great infancy and is getting stuck into Year 1 with confidence. That confidence is what we wish for all our patients and families and your letter provides great affirmation.
Thank you so very much for taking the time to write to me. I am most grateful.
with best wishes,
Jonathan Britto,  January 2018

 

Craniofacial surgery requires knowledge from a broad spectrum of specialities and is therefore considered multidisciplinary. Jonathan’s craniofacial work at Great Ormond Street Hospital led to his award of the Syme Professor Medal of the Royal College of Surgeons of Edinburgh.

 

Complex planning in orbital reconstruction for a teenager with left sided hemifacial microsomia, Jonathan Britto and Professor Richard Hayward, Great Ormond Street, 2012

HFM scan 2 HFM scan 1

The craniofacial team plans craniofacial care for the long term. We want to  build a change to protect function, say, of the eyes, or breathing, and we want to make appearance change that brings confidence. This is not aesthetic surgery, although we might use aesthetic surgery techniques from time to time.

This in turn, brings greater psychological health and comfort and makes the living of life so much more fulfilled. That is where the professional reward comes. We know that although we cannot change society, we can make a personal and family change, an increase in confidence, in a step by step, little by little approach – sometimes punctuated by big operations – but always in a context of care.

Jonathan Britto

HPT planning asymmetrical HPT planning 2 HPT diagram robyn davies scan image

Three – dimensional planning and model surgery refines surgical care – whether it be bone cuts and bone movement (osteotomy) or onlay facial implants in planning for facial shape change. Jonathan uses 3D model surgery and computer assisted planning in facial implant surgery, craniofacial surgery and rhinoplasty techniques.

axial HPT Van der meulen classificn axial planning in HPT

Facial shape change moves the ‘soft tissue envelope’ – detailed planning allows a greater prediction of soft tissue change and ultimately a prediction of the accuracy of appearance change and aesthetic balance. For more information, please contact Jonathan to find out more about his craniofacial work.

L’Hopital Les Enfants Malades, Paris

Paris is the modern birthplace of craniofacial surgery, and this unit, now led by Dr Eric Arnaud, President of the International Society of Craniofacial Surgery, was founded by Dr Daniel Marchac.

Dr Marchac, a true pioneer of craniofacial surgery, trained both Dr Arnaud and Mr Jonathan Britto as Fellows in the latter part of their craniofacial apprenticeship, prior to their each assuming consultant responsibility. Jonathan Britto currently holds a visiting position in Paris and works with the Necker team.

The Hospital for Sick Children, Toronto, Canada

The craniofacial programme at ‘Sick Kids’ Toronto, Canada, is the biggest in the North Americas, and provides excellence in craniofacial care and research. Jonathan Britto was craniofacial fellow for a year in 2003-4 prior to his consultant appointment in the UK.

He was delighted to have been invited back as the Vale Visiting Professor to the department in the Summer of 2014.

The Craniofacial Unit, Great Ormond Street Hospital, London

The craniofacial unit at ‘GOS’ is one of the four UK designated centres in craniofacial surgery, providing UK and international craniofacial care under the benchmark auspices of NHS England. Jonathan Britto began his craniofacial training as Fellow to the unit in the late 1990’s, and was later appointed to an Honorary consultancy in 2006, before taking up a substantive consultant post in 2008 in conjunction with his consultancy in the Transitional and Adult Craniofacial Service at University College Hospitals.

 

FTW logo   ‘Facing the World’ is a pioneering charity advocating and supporting the craniofacial care of disadvantaged children from around the globe. The craniopagus twins, Rital and Ritag, divided in a series of operations by the craniofacial care team at Great Ormond Street Hospital , were provided their care by the financial and clinical support of the Facing the World team. The news was widely covered in the media and in international professional conferences, where the clinical experience and planning were shared with other teams.

‘Craniopagus Twins – building on a staged approach to separation’     

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