Abstract
Down Syndrome is a genetic disorder caused by a third copy of chromosome 21. One of
the main feature of the syndrome is the facial dysmorphism, characterized by broad,
flat face, oblique eyelid rhymes, skin folds at the inner corner of the eyes (epicanthus),
receding chin, protrusion of the tongue. These features are often social and functional
obstacles, reducible with surgical interventions. The first facial plastic/cosmetic
surgery approaches on Down children were performed in 1960 in Germany, Great Britain
and the United States, where plastic surgeons began to reshape the Down patients physiognomy
through the surgical correction of the face, tongue, eyes, nose, of the nostrils,
of the neck. Recent studies have shown that in spite of the tendency to infections
and early pulmonary hypertension in children with DS, surgery is not contraindicated,
as previously suggested, but can be performed with very good results. This treatment
has aesthetic, functional, rehabilitative, social effects, as well as favorable outcome
on the familiar behavior. However different issues emerge in cases of patients presenting
intellectual disability and unable to understand the consequences or the side effects
related to plastic surgery. In this aspect, different Countries have enacted distinct
laws directly regulating the consensuses for such intervention, with the goal to reduce
the risks for the affected patients and the respect of their willing and social inclusion.
Keywords
Down's syndrome - plastic surgery - face - neurological outcome - behavior