The Pediatric Craniofacial Program at UBNS
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Caring & Compassionate Craniofacial Specialists
For decades, UBNS has been proudly offering comprehensive, customized care for children with craniosynostosis and other craniofacial conditions. Our pediatric craniofacial team is dedicated to helping families navigate their child’s diagnosis and treatment options, collaborating to create customized treatment plans, and using our expertise to ensure the best possible outcome for every child we see.
Our world-renowned pediatric craniofacial specialists have experience treating children with a wide range of craniofacial conditions using both surgical and non-surgical methods. They also have a high level of familiarity with some of the most advanced medical technology available, including Virtual Surgical Planning. We know every child and every diagnosis is different – which is why we treat each case individually and come up with a plan customized to each patient.
The UBNS Approach to Craniofacial Care
UBNS is the largest pediatric craniofacial center in Upstate New York, but our craniofacial specialists have experience treating children from all over the world. That expertise and experience, along with the innovative techniques we use to offer customized care, set us apart from other craniofacial programs.
Customized Care for Your Child
At UBNS, we don’t have one specific procedure we specialize in or use across the board for pediatric craniofacial patients. Our doctors have extensive experience performing a wide range of procedures and can adapt each option to meet the needs of each individual patient. This means treatment or management plans are tailored to your child and their needs specifically.
We understand each treatment option we offer has different pros and cons – and that your family may be searching for a specific solution you feel will work best for your child. The UBNS pediatric craniofacial team is committed to involving your family in every step of the decision-making process. They’ll ensure you’re fully informed of the treatment options available and have all the information you need to make the right decision for your child.
Multidisciplinary Collaboration
Comprehensive, customized care means your child’s care team includes doctors and specialists from a wide range of disciplines that cover every aspect of the treatment plan. Pediatric Neurosurgeon Dr. Renée Reynolds and Craniomaxillofacial Surgeon Dr. Michael Markiewicz lead the craniofacial team, but will collaborate closely with other specialists to determine the best treatment option for your child.
“We take a multidisciplinary approach and collaborate together to figure out which treatment option is going to be most beneficial and relevant to achieving each individual patient’s goals – and the patient’s family is part of that decision-making process.”
– Dr. Renée Reynolds
Our specialists cater to the specific needs of each patient. Your child’s care team may include:
- Pediatric Neurosurgery – Diagnoses and treats conditions of the head, spine, or nervous system in children
- Craniomaxillofacial Surgery – Diagnoses and treats facial, skull, and jaw deformities
- Genetics – Identifies potential genetic causes of craniofacial disorders
- Orthodontists – Monitors orthodontic development and makes corrections as needed
- Child Psychology – Provides emotional and mental support for craniofacial patients throughout treatment and development
- Pediatric Dentistry – Monitors the teeth and gums of patients and provides treatment as needed
- Pediatric Otolaryngology (Ear, Nose, and Throat) – Monitors and treats any potential impacts to ears, feeding, and breathing
- Pediatrics – Provides support and treatment for all medical problems related to a patient’s craniofacial condition
- Social Work – Provides non-medical support for craniofacial patients and families throughout the treatment plan
- Nursing – Coordinates care and facilitates communication throughout the treatment plan
- Speech Language and Pathology – Monitors speech and communication skills throughout development and provides treatment as needed
- Audiology – Monitors hearing throughout treatment and development
Why Choose UBNS?
Your child’s craniofacial diagnosis can be overwhelming – it’s stressful trying to identify and consider all the options available for how and where to treat them. At UBNS, we know these cases require a dedicated team that’s highly experienced and up-to-date on the latest advancements in the field.
In addition to providing customized and comprehensive care, our pediatric craniofacial team brings a high level of expertise and innovation to ensure your child is getting the best care possible.
“We really try to think of each child as if they were our own and treat them like that, and try to relate to each family like they’re our family.”
– Dr. Michael Markiewicz
Cutting-Edge Innovation
Our doctors at UBNS are on the cutting edge of pediatric craniofacial care advancements. Whether it’s incorporating new, less invasive surgical techniques in treatment plans or utilizing the latest technology to augment treatment, our team is always looking for new ways to improve care and ensure optimal outcomes.
The innovative technology we use, including Virtual Surgical Planning and Custom Guides, allows us to further customize treatment for each patient we see and take a more eloquent, detailed approach to surgery. Our team at UBNS has been at the forefront of using these technologies and now has some of the most extensive experience in the field.
Virtual Surgical Planning
Surgery can be scary – both for your child and for you. At UBNS, we eliminate the fear of the unknown by using Virtual Surgical Planning for all pediatric craniofacial cases. This technology helps us create a customized plan before surgery to improve the outcome and shorten the amount of time your child spends in the operating room.
Virtual Surgical Planning involves software that allows us to create computerized models of your child’s head. Our surgeons use those models to plan exactly what the surgery is going to entail, including every cut they’re going to make, and can even predict the physical outcome of the procedure.
The computerized models we generate during Virtual Surgical Planning can also be used to create a Custom Guide, or a 3D-printed replica of your child’s skull. Similar to the computerized models, the guide gives our surgeons an opportunity to outline which cuts they’re going to make and which bones are going to be moved, effectively mapping out a reconstruction before they even enter the operating room.
Second Opinions You Can Trust
Before deciding on or beginning a treatment plan for your child’s craniofacial condition, it’s important to be fully aware of all the options that are available to you. If you’ve seen a specialist but are looking to explore other options or want a second opinion on a treatment that’s been recommended for your child, our pediatric craniofacial team can provide another perspective.
The UBNS craniofacial team can meet with you in person or virtually to provide a second opinion on your child’s diagnosis or treatment. They’ll perform a comprehensive evaluation of your child’s condition and make recommendations on which surgical options they believe are best suited for your child based on the diagnosis and treatment goals. Our doctors will also give you a full walk-through of what the treatment process involves, from surgery and follow-up to continuity of care throughout development.
Unmatched Expertise
As a program, UBNS has successfully treated thousands of children with craniofacial conditions over the last several decades. As individuals, our pediatric craniofacial specialists are some of the most highly trained and experienced doctors in the world.
Having trained in Seattle at one of the largest craniofacial centers in the United States, Dr. Reynolds was exposed to an unprecedented volume of cases that helped her develop a high level of comfort as a pediatric neurosurgeon.
Dr. Markiewicz is a dual-trained dentist and physician who’s internationally known for his expertise and experience in treating craniofacial abnormalities.
Both Dr. Reynolds and Dr. Markiewicz are heavily involved in the craniofacial and pediatric neurosurgery communities and have been recognized for their innovative work in the field. In addition to authoring peer-reviewed articles, scientific abstracts, and other publications, both doctors have held leadership positions on various boards and have been invited to speak and share their expertise nationally and internationally.
Contributions to Their Fields
Dr. Markiewicz:
- 104 peer-reviewed publications
- 130 national & international talks
- 5 books edited
- 42 book chapters
- 74 scientific abstracts
Dr. Reynolds:
- 51 peer-reviewed publications
- 44 national & local talks
- 6 book chapters
- 25+ scientific abstracts
Craniofacial Conditions We Treat
Craniosynostosis (Syndromic & Nonsyndromic)
Craniosynostosis is a condition where the spaces (also known as sutures) between a baby’s skull bones close and the bones fuse too early. That premature fusing can impact the growth of a baby’s skull or brain and put pressure on certain bones, causing an uneven or misshapen head.
There are several different types of craniosynostosis, including syndromic and nonsyndromic.
Nonsyndromic craniosynostosis has an unknown cause, and is the most common kind of craniosynostosis. These cases are classified based on which sutures in the baby’s skull fuse too early. The different types of nonsyndromic craniosynostosis are:
- Sagittal: Impacts the sagittal suture that extends from front to back at the top of the head
- Unicoronal: Impacts either of the coronal sutures that extend from each ear to the top of the head
- Bilateral coronal: Impacts both coronal sutures
- Metopic: Impacts the metopic suture that runs from the bridge of the nose to the forehead
- Lambdoid: Impacts the lambdoid suture across the back of the head
Syndromic craniosynostosis is caused by different genetic syndromes, including:
- Crouzon Syndrome
- Apert Syndrome
- Pfeiffer Syndrome
Craniomegalic Skulls/Macrocephaly
Pediatric craniomegaly and macrocephaly are conditions where a child’s head or skull is larger than normal for their age. These conditions can be benign, but may also indicate a more serious underlying condition.
Plagiocephaly
Plagiocephaly, also known as flat-head syndrome, is a condition that causes a baby to develop a flat spot either on the side or the back of the head. These flat spots are typically caused by pressure from sleeping or laying in one position for extended periods of time.
Fibrous Dysplasia
Fibrous dysplasia is a condition that involves fibrous tissue replacing bones within the body. This can cause uneven growth, weakened bones, and asymmetry.
Fibrous dysplasia can happen anywhere in the body but can be treated by our pediatric craniofacial specialists when it impacts the skull or facial bones.
Frontonasal Dysplasia
Frontonasal dysplasia is a disorder caused by a gene mutation that impacts the development of the head and the face. The condition can cause a cleft in the nose, a wide space between the eyes, a groove in the face, or a combination of these abnormalities.
Trauma
In addition to treating a wide range of conditions and birth defects, our pediatric craniofacial specialists can also treat and correct abnormalities caused by trauma.
Cleft Lips & Palates
Cleft lips refer to a split in the upper lip. Cleft palates are splits in the roof of the mouth. These are two of the most common birth defects. Babies may be born with one or both conditions.
Craniofacial Treatment at UBNS
At UBNS, we know the best way to achieve an optimal outcome for your child is to find the treatment plan that works for them specifically.
We work closely with families to find the right option for each individual patient. Our specialists offer both surgical and non-surgical treatment options and will develop a customized care plan tailored to your child.
“We perform any treatment you can imagine in the craniofacial realm, but we’ll adapt it to what’s needed for that patient.”
– Dr. Markiewicz
What to Expect from Treatment
While every case is different and treated individually with a customized plan, the approach we take and the process we follow is similar for each case.
After Dr. Reynolds and Dr. Markiewicz meet with your family, they’ll work closely with other specialists to develop a treatment plan tailored specifically to your child. The team will carefully consider several factors, including:
- Diagnosis
- Age
- Family Priorities
- Lifestyle
- Goals for Treatment
One of the biggest factors we take into consideration is age, because some treatment options are extremely time-sensitive. For example, endoscopic repairs and other less-invasive surgical options are typically best suited for patients under six months of age to ensure the best outcome. After six months of age, the more traditional open and invasive procedures are better suited – usually within the first two years of life for optimal effectiveness.
It’s important to note that each patient is different and these exact timelines may not apply to your child. Our doctors will be able to provide a more precise, customized time frame after meeting with you.
Recovery time also varies by case and patient, but most patients who undergo a surgical procedure typically only stay a few days in the hospital before going home.
Some of Our Treatment Options
Craniofacial Surgery
Cranial Vault Reconstructions
Cranial vault reconstruction is a surgical treatment option that allows our neurosurgeons to correct skull bones that fuse prematurely and cause abnormalities.
To treat craniosynostosis, we offer both endoscopic and open cranial vault reconstruction surgery. Endoscopic surgeries involve smaller incisions and a camera that gives our neurosurgeons a thorough internal view of the skull. Open reconstruction surgeries are traditional, more invasive procedures.
Spring-Assisted Corrections
Spring-assisted correction is a treatment option that involves surgically inserting springs to push bones in the skull apart over a period of time, reshaping the head.
Distraction Corrections
Similar to spring-assisted corrections, distraction corrections are surgical procedures designed to create space between skull or facial bones. During a distraction correction procedure, our neurosurgeons cut a bone and insert a device called a distractor. The distractor pushes the two parts of the bone apart over time, which causes new bone to form between the pieces.
Craniofacial Therapy
Helmet Therapy
Helmet therapy is a non-surgical treatment option that may be appropriate for certain craniofacial conditions like macrocephaly and plagiocephaly. It involves fitting a child with a helmet that helps distribute pressure more evenly over the skull, helping to reshape the head.
Continued Care for Your Child
Our pediatric craniofacial specialists are with your family every step of the way – from diagnosis to planning and carrying out treatment. But the treatment plan we develop doesn’t just cover the initial surgery or therapy.
After performing surgery or overseeing therapy treatment, our team stays actively involved with patients throughout their developmental years. Our doctors will monitor your child’s growth, clinical status, and neurological development to ensure we’re seeing the expected outcome of treatment.
Following our patients for several years after treatment helps us identify whether additional interventions are necessary.
“We enjoy getting to know our patients and their families from diagnosis and watching these children grow and develop throughout their youth as their craniofacial family.”
– Dr. Reynolds
Meet Our Pediatric Craniofacial Team Leaders
Dr. Renée Reynolds
Dr. Renée Reynolds is a pediatric neurosurgeon with more than 11 years of experience treating pediatric craniosynostosis and other craniofacial conditions.
Dr. Reynolds trained in Seattle at one of the largest craniofacial centers in the world, where she was exposed to a high volume of complex cases from patients all over the world. That experience helped her develop a high level of comfort and expertise that she’s continued to build on throughout her career.
In addition to being the Medical Director of Pediatric Neurosurgical Outreach and Education at Kaleida Health, Dr. Reynolds also serves as a Clinical Associate Professor of Neurosurgery at the State University of New York at Buffalo and is the Program Director of the Department of Neurosurgery’s Academic & Residency Program.
Dr. Reynolds has been the scientific program chair for two recent meetings of the American Society of Pediatric Neurosurgery.
Read the latest medical articles from Dr. Reynolds
“It’s an honor and privilege to treat patients with craniofacial needs throughout Western New York and beyond. These are complex conditions that require a specialized team – and Dr. Markiewicz and I aim to provide the highest quality and most advanced craniofacial care for the patients we serve.”
– Dr. Reynolds
Dr. Michael Markiewicz
Dr. Michael Markiewicz is a dual-trained dentist and physician who’s dedicated his professional career to the surgical correction of craniofacial conditions. He has 10 years of experience treating pediatric craniofacial patients as an oral and maxillofacial surgeon.
Dr. Markiewicz is the Chairman of the Department of Oral and Maxillofacial Surgery at the State University of New York at Buffalo, as well as the Associate Dean for Hospital Affairs and a Professor of Oral and Maxillofacial Surgery, Surgery, and Neurosurgery at UB.
In addition to his leadership positions, Dr. Markiewicz served as the Oncology and Reconstruction and Oral and Maxillofacial Surgery Section Editor for the Journal of Oral and Maxillofacial Surgery in 2024 and the Craniofacial Surgery and Oral and Maxillofacial Surgery Section Editor for The Cleft Palate-Craniofacial Journal in 2021.
Read the latest medical articles from Dr. Markiewicz
“I’ve dedicated my professional life to treating children and adults with congenital and acquired facial deformities, and working with a comprehensive multidisciplinary team along with my partner Dr. Reynolds has allowed us to treat children with the highest level of care.”
– Dr. Markiewicz
Dr. Veetai Li
Dr. Veetai Li is a pediatric neurosurgeon with more than 30 years of experience treating children with conditions related to the brain, spine, and more. He specializes in the study and management of pediatric brain tumors, spinal malformations, spasticity management for children with cerebral palsy, and surgical treatment for seizures.
After graduating from Albany Medical College, Dr. Li completed residency training in neurosurgery at the University of Wisconsin Hospital. He then received fellowship training in pediatric neurosurgery at the Children’s Hospital of Pittsburgh.
Dr. Li is the Chief of Service of Pediatric Surgery and Medical Director of Pediatric Neurosurgery at UBNS, the Medical Director for Neurosurgery/Epilepsy at Kaleida Health’s John R. Oishei Children’s Hospital, and a Clinical Associate Professor of Neurosurgery at the State University of New York at Buffalo. In addition to these roles, he is also a member of national organizations, including the American Society of Pediatric Neurosurgeons, the Joint Section of Pediatric Neurosurgery, and the Children’s Oncology Group.
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