Dr. Stephen Baker

Georgetown University Plastic Surgeon

6845 Elm Street Suite 603 | McLean, VA 22101 | Phone: (202) 444-9302

The American Society of Plastic Surgeons

Dr. Baker's Approach to Reconstructive Facial Surgery

Dr. Baker is one of Washingtonian's Top Doctors for Cosmetic and Craniofacial surgery. He serves as the Co-Director of the Inova Fairfax Craniofacial Program, as Section Chief of the Division of Craniofacial Surgery at Georgetown University Hospital, and he has edited a textbook on craniofacial surgery. Craniofacial surgery is a subspecialty of plastic surgery that focuses on surgery of skeletal and soft tissues of the face, skull, and orbits. However, it does not include the formal training dental and maxillofacial training that one receives in a full oral and maxillofacial surgical residency. Dr. Baker has doctoral degrees in both dentistry and medicine and has completed full residency and fellowship training in oral & maxillofacial, plastic, and craniofacial surgery. His 15 years of training after college give him unparalleled expertise in assessing and restoring facial proportion and structure of both the soft tissues and the underlying skeletal structures of the face. Dr. Baker is one of the only specialists in the United States with formal, recognized training in maxillofacial, plastic, craniofacial, and pediatric plastic surgery.

Post-traumatic Deformities

Many traumatic accidents involve the entire face. Dr. Baker has extensive experience in improving both the appearance and the function of these patients. His research in soft tissue reconstruction and experience in maxillofacial, plastic, and craniofacial surgery give him extensive experience in this type of surgery. Dr. Baker treats acute facial injuries, but also treats patients with post-traumatic deformities. These are patients who have had their initial injuries treated previously but suffer from residual functional or aesthetic deformities. For dental and jaw reconstruction, Dr. Baker works closely with a team of orthodontists and prosthodontists. Using a team approach, he can place bone grafts, dental implants, and move the jaws and teeth into their original position to restore the preoperative function of the patient. Dr. Baker has published and presented treatment algorithms he has developed specifically for patients who have suffered traumatic injuries to the face.

Cleft Lip and Palate

One of the most common conditions encountered at our craniofacial clinic is the infant, child, or young adult with a cleft lip and/or palate anomaly. These patients may present as infants with unrepaired clefts, as recently adopted children from foreign countries, or as patients who are new to our team but have a history of care with another team.

Ideally, parents who have a prenatal diagnosis of cleft lip/palate should seek a prenatal visit with the team prior to the delivery of their child. Most parents have little idea of what this diagnosis means for their new baby. The goal of our team is to meet with every family diagnosed with a cleft on prenatal ultrasound to educate and reduce anxiety prior to the delivery of their newborn. Dr. Baker makes every effort to support and empathize with the family, and through education and engagement transform the uncertainty, anxiety, and fear that are commonly associated with this diagnosis into acceptance, love, pride, and happiness. This is accomplished by showing the families before and after photos, videos, and television clips from our team. Many of my patient’s parents are the best resource for new families and Dr. Baker strives to facilitate communication between new and experienced families.

An additional goal of the prenatal visit is to educate the parents about the feeding of their new baby. Many children with cleft palates will not be able to adequately breast feed nor take milk or formula well from a standard bottle. A prenatal meeting with a speech/feeding specialist will educate the parents on the optimal approach for feeding their new baby. Not only are the parents educated in technique, but they are also provided with various feeding bottles so that they will have everything they need, even if the hospital at which they deliver does not. Although most nurses are knowledgeable in the feeding of children with cleft palates, it is always best to be prepared.

Once the child is born, the family will present for an initial evaluation by the craniofacial team. Specialists in plastic/craniofacial surgery, otolaryngology, genetics, orthodontics, oral and maxillofacial surgery, speech pathology, audiology, pediatric dentistry, and maxillofacial prosthodontics will be present to evaluate each patient in a single setting. This approach minimizes patient transport time and allows the patient to gain immediate feedback from a multitude of cleft care professionals at a single appointment.

Nasoalveolar molding, or NAM, is a method to shape and improve the form of both the lip and nose prior to surgery. Because the maternal estrogen circulates for several weeks in the newborn, the orthodontist can shape the nasal cartilage nonsurgically. As the maternal estrogen dissipates, the nose retains the new shape of the nose. Additionally, NAM corrects the abnormal position of the upper jaw and minimizes the deformity of the soft tissue elements of the lip. Because the orthodontist is able to nonsurgically minimize the lip and nose deformity prior to surgery, the surgeon has much less of a deformity to correct at the initial surgery of lip and nose repair. Studies have demonstrated that NAM reduces the number of subsequent surgical revisions necessary to obtain an ideal result. Dr. Baker is fortunate to work with the only orthodontist in the DC Metro region specifically fellowship trained in this technique.

After the initial lip and nose repair, subsequent care frequently includes cleft palate repair, dental treatment, orthodontics, alveolar bone grafting, orthognathic (jaw) surgery, and possible nasal surgery. These surgeries take place at specific ages of the patient and range from newborn to adolescence. Dr. Baker takes great pride in providing optimal care to provide the best treatment possible for these patients through adolescence and young adulthood. Dr. Baker is the only few craniofacial surgeon in the midatlantic region with formal, recognized training in plastic, maxillofacial, pediatric plastic, and craniofacial surgery. He incorporates both his dental and plastic surgical experience to provide the best results at every stage of treatment.

Facial Tumors

Dr. Baker has national and international patients that he treats for extensive tumors of the face. He has published reports of novel approaches to tumor treatment that result in less damage to normal structures and decreased rates of recurrence. Dr. Baker takes pride in offering treatments that minimize scarring and recurrence. Please see photos.

Craniofacial Synostosis

Dr. Baker treats patients born with craniosynostoses. Many of these children require multiple operations on the skull and some even on the face and jaws. Dr. Baker is fully capable of performing all stages of surgery including the later stages that require jaw movement. Both Georgetown and Fairfax Hospitals provide specialists in pediatric anesthesia and post-operative care in a dedicated pediatric ICU.

Rhinoplasty (nasal surgery): is one of the most commonly performed procedures by Dr. Baker. He performs both reconstructive and cosmetic rhinoplasties. Many of his patients come to him after having had previous nasal surgery, and he frequently treats patients who present with nasal anomalies secondary to trauma, congenital anomalies, or cancer. These problems require advanced techniques. Revision rhinoplasty is one of Dr. Baker's specialties, and he is currently writing an operative atlas on rhinoplasty surgery. Please see photos

Learn More about Rhinoplasty

Orthognathic (jaw) Surgery: requires establishing ideal occlusion with the jaws in the most aesthetic facial position. Dr. Baker has written many chapters on orthognathic surgery. His goal is to employ the aesthetic principles of plastic surgery to place the jaws in the ideal functional position but enhance facial aesthetics as well. As a plastic surgeon, he is skilled in assessing facial proportion and aesthetics. He specializes in obtaining the ideal aesthetic result while optimizing occlusion. As an oral and maxillofacial surgeon, he is skilled in the nuances of occlusion and dental anatomy. There are many jaw movements that restore occlusion but often there is one that is ideal in terms of optimizing facial aesthetics and achieving functional goals. Please see photos

Click here to read descriptions on procedures available by Dr. Baker.