Beyond reconstruction: minimally invasive aesthetic and regenerative medicine in postoperative oral and maxillofacial surgery

Abstract Purpose Oral and maxillofacial reconstruction restores anatomical continuity and function after tumor resection, trauma and congenital deformity, yet patients frequently remain affected by fibrosis, scar tethering, impaired oral competence, asymmetry and altered dynamic facial function. These deficits can impair quality of life, social interaction and body image. Conventional revision surgery carries additional morbidity, and minimally invasive options have emerged as a postoperative adjunct. This article reviews how minimally invasive aesthetic and regenerative medicine can extend reconstructive rehabilitation in oral and maxillofacial surgery. Methods Current biological and clinical evidence for polynucleotides (PN), hyaluronic acid (HA) and botulinum toxin A (BoNT-A) was reviewed and integrated with selected, non-consecutive illustrative cases from a dedicated aesthetic and regenerative consultation in an academic oral and maxillofacial surgery department. Clinical applications were illustrated across four patient categories: oncological, congenital, trauma/scar and aesthetic-functional sequelae after surgery. Results In illustrative cases from different categories, a staged approach of tissue conditioning, structural restoration and dynamic neuromodulation was associated with clinically observed and patient-reported improvements in scar pliability, tissue gliding, oral competence, dynamic symmetry and quality of life. PN were used primarily for regenerative tissue conditioning, HA for reversible structural restoration, and BoNT-A to modulate muscular imbalance and pathological wound tension. As interventions were frequently combined and no validated outcome measures or controls were used, these observations are hypothesis-generating. Conclusion Minimally invasive regenerative and aesthetic treatment may serve as a functional extension of reconstruction rather than a cosmetic adjunct. The central concept is not volumisation, but restoration of tissue quality, dynamic balance and facial function. Prospective studies using validated functional, scar and patient-reported outcome measures are required to define its role in modern oral and maxillofacial surgery.