Hemifacial Microsomia

What is Hemifacial Microsomia

Hemifacial Microsomia is a genetic disorder whereby one side of the face is underdeveloped. Roughly one in 5,000 individuals are affected by Hemifacial Microsomia. Of those with this condition, 15% will have underdevelopment on both sides of their face. Sometimes Hemifacial Microsomia can lead to Goldenhar Syndrome when the eyes are affected.

Hemifacial Microsomia is one of the most common facial birth defects, being second only to cleft palate.

Those with Hemifacial Microsomia have an asymmetrical face, and a malformed ear and underdeveloped jaw on the affected side of the face. Eating is often difficult due to an abnormal bite, and hearing loss due to the underdevelopment or absence of the ear.

Other common characteristics of Hemifacial Microsomia include lateral oral clefts, a lack of or dysfunctional facial nerves on the affected side of the face, diminished soft tissue of the cheeks, short mandible on the affected side of the face, a shifted chin and small or absent ears.

Treating Hemifacial Microsomia

The best treatment option will be determined by the severity of one’s Hemifacial Microsomia symptoms. Some children with very mild cases of Hemifacial Microsomia may not need treatment. Those with moderate to severe cases of Hemifacial Microsomia will likely need surgery.

Common treatment options include:

  • Jaw surgery, sometimes using bone grafting
  • Ear reconstruction surgery
  • Surgery to address changes in the soft tissue of the eyes and lips
  • Nerve grafting
  • Muscle transfer surgery

Some of these surgeries involve multiple surgeries. Lip and eye tissue reconstruction surgery can be done before a child turns two. Jaw surgery can be done as early as age three. Many of the other recommended or required surgeries will begin around ages 6-8.

Some surgeries, such as that which reconstruct the ear require the child to be a certain minimum size and to have enough bone cartilage, which keep the surgeries from being done at an earlier age.

At the Cleft & Craniofacial Institute of Utah, we know that every Hemifacial Microsomia case is different. Our medical professionals will diagnose and make individualize treatment recommendations to ensure the best quality of life for each patient.

Untreated Hemifacial Microsomia

Those with Hemifacial Microsomia often lead normal lives and experience no adverse learning or mental disabilities. Medical treatment, however, can correct deformities and lead to an improved quality of life.

Potentially serious complications can occur if one’s Hemifacial Microsomia isn’t treated. These complications can include:

  • Spinal malformation
  • Heart defects
  • Difficulty eating
  • Difficulty breathing
  • Difficulty with hearing and speaking
  • Difficulty opening the mouth
  • Crooked teeth
  • Limited facial muscle movements
  • Nerve problems
  • Vision problems

Additional Information

Contact the Cleft & Craniofacial Institute of Utah today to set up a consultation with our doctor to learn more about the available treatment options for your child’s Hemifacial Microsomia case.


Our Expertise

Cleft Lip/Palate

 Cleft lips and palates are one of the most common birth anomalies that affect about 1/600 newborn babies in the United States and around 1/500 in the state of Utah.  Clefts can range from quite mild to fairly severe.  Most of the time they are an isolated anomaly, but are also associated with a number of gentic syndromes.  Depending on what structures are involved dictates the complexity of the treatment plan.   Our team works together with you to make a customized plan for  your baby.  Even the most severe of cases should be able to be treated with only a few surgical interventions by a well coordinated and efficient team.






The skull is made up of several different bones that are joined together by growth plates called "sutures."  Craniosynostosis is a condition where one or more of these sutures fuse prematurely causing an abnormal head shape, decreased cranial volume, and the possiblilty of raised intracranial pressure.  The treatment of craniosynostosis is surgical and the goals of surgery are to increase the volume of the skul and to correct the abnormal appearance of the head shape.  There are two methods of surgical correction: open vault reconstruction and strip craniectomy.  Dr. Griner's extensive training allows him to perform these complex procedures without the need for blood transfusions and spending only 1-2 nights in the hospital. 



There are many syndromes that can affect the shape of the head and face and include Aperts, Crouzon, Pfieffer, Treacher Collins, and many others.  Most of these syndromes include many other complex anomalies and need to be treated in a coordinated approach in order to reduce the number of operations the child will need.  These syndromes are rare and require specialists that are very familiar with the intricacies of each syndrome.  Dr. Griner's unique training provided him with extensive experience with craniofacial syndromes and makes him the premier choice to guide the management of your child's needs in Utah.





Ear Deformities

Ear deformities range from mild changes in shape to the complete abscence of an ear and deafness.  Mild deformities can be treated in the first few weeks of life while others will require reconstructive surgery and hearing aids.  No matter the severity, our specialists work together to provide normal appearance and improved hearing.


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