Craniofacial Endoscopic Surgery: Trend of the Past Moving Into Reality of the Future

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At one point in the turn of this new century our predecessors, mentors, and colleagues predicted that the new innovations and their resulting advances came from the academic institutions and their designated academic medical centers. That was for a legitimate reason; all the resources were always available in those institutions. However, that was the impetus for many with the abundance of funding was a major attraction to the brightest and energetic surgeons who were willing to work for minimal compensation to get inspired by the great mentors and the shakers of the surgical world. That really happened with most of us, the “traditional generation.” We are proud of our label, trend and the era we survived in our early careers. Then came new advances from outside the fortress of knowledge as they moved the monopoly. As one of my colleagues said, endoscopic surgery produced a violation to that tradition and opened the doors to everyone in the world to persue their dreams and be whatever they want to be. In other words, as innovation removes boundaries and artificial walls it comes to produce an environment open to all, similar to how we removed the boundaries of ethnicity, religion, and skin color to advancement and innovation. Industry jumped into the occasion.
Even though endoscopic techniques were present at the turn of the century and the material was there to start with, it was limited to looking into hollow organs and not violating the cutaneous elements. But when a group of surgeons on the East Coast of the US crossed the barrier to enter the abdominal wall and proved that a better outcome with less morbidity and mortality than the open traditional methods was the outcome expected and was achieved as well as shorter stay than with the traditional manner. That opened a whole new era not in just one specialty, but in all surgical specialties. The industry jumped at the opportunity of a new venture and worked on using their ingenuity and skilled engineers with the surgeons to advance the new specialty to the present ceiling with the advanced instrumentations. We in plastic surgery got there first and then found some limitations, but continued to insist that the endoscope is here to stay and it is part of our armamentarium in plastic surgery, and all the instrumentations are there to help the surgeon achieve a better outcome. Specialty lines were crossed and better outcomes were noted. It took then a young plastic surgeon from the Southeast to have more courage to remove an orbital tumor on a child with no scar, and a West Coast plastic surgeon with more courage to repair a fractured mandibular condyle with almost no morbidity and a great outcome. Both used newly devised endoscopic techniques. We can then say the glass ceiling opened up and the limit is now the sky or the imagination of the operating surgeon. You can see that all over the pages of this issue, in previous issues, and in future issues. However, the advances in global craniofacial surgery as part of plastic surgery have skyrocketed in the last decade. The endoscopic avenue has become the new frontier. A need for regulatory standard is now there.
We all look for the future and what may happen and what advances may ensue, but the future is here, and we are practicing it on a daily basis. I may say for those who predicted that the future would be bleak; you get an F for your prediction skills.
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