The scope of craniomaxillofacial surgery has expanded dramatically over the past century, driven less by incremental progress than by episodic paradigm shifts and the interdisciplinary collaboration that made them possible. From the reconstructive efforts of Gillies in the early 20th century to the craniofacial revolutions of Tessier and McCarthy, the field has continuously redefined its boundaries. This paper examines the historical development, philosophical underpinnings, and contemporary opportunities for scope expansion in craniomaxillofacial surgery. Through analysis of training models, emerging technologies, and institutional strategy, we propose a framework for the next paradigm shift in craniofacial and maxillofacial surgery; 1 integrating virtual surgical planning, biologic reconstruction, and systems-based leadership. Expanding the scope of practice in craniomaxillofacial surgery will not happen passively. It requires claiming complex cases, measuring outcomes that matter to patients, and training surgeons who lead multidisciplinary teams rather than defer to them. The future of craniomaxillofacial surgery depends on our willingness to redefine its borders rather than simply defend them.
Robin J. Evans (Mon,) studied this question.