Original face for the craniofacial surgeons

Article information

Arch Craniofac Surg. 2020;21(1):1-2
Publication date (electronic) : 2020 February 20
doi : https://doi.org/10.7181/acfs.2020.00052
Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea
Correspondence: Kun Hwang Department of Plastic Surgery, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea E-mail: jokerhg@inha.ac.kr
The author thanks Nooraini Mydin, MA, Journalist, for English editing.
Received 2020 February 18; Revised 2020 February 18; Accepted 2020 February 19.

In Zen Buddhism (禪佛敎), original face (本來面目) is a term pointing to the non-duality of subject and object [1]. The term original face originates from Huangpo’s Chuanhsin fayao (857) and the Hui-sin edition (967) of the Platform Sutra of the Sixth Patriarch (六祖壇經) [2]. A topic, “What is your original face before your parents were born?” tells us to let go of even more of our conditioning.

As Eastern Zen Buddhism seeks for the “my face before my parents were born,” a similar concept of face can be found in Western literature: “The face I had before the world was made.”

This other original face is the face of a person which she or he had before the world was made. In a poem titled “Before the World Was Made,” Irish poet Yeats writes from the perspective of a beautiful woman responding to a jealous lover. She begins by acknowledging her efforts to make herself more attractive with cosmetics.

If I make the lashes dark

And the eyes more bright

And the lips more scarlet,

Or ask if all be right

From mirror after mirror,

No vanity’s displayed:

I’m looking for the face I had

Before the world was made.

Then, what is original face of the craniofacial surgeons?

Congenital craniofacial abnormalities are a group of defects caused by abnormal growth and/or development of the head and facial soft-tissue structures and/or bones. Among them, cleft lip, cleft lip and palate, and isolated cleft palate are the most common congenital anomalies of the head and the neck, with a total prevalence of 2.1 per 1,000 live births. The ultimate treatment for this malformation is surgical closure.

Dr. Millard (1919–2011), in the preface of his famous book Cleft Craft: The Evolution of Its Surgery (Fig. 1) emphasized surgeon should not ignore the first principle of plastic surgery; know the normal. He wrote “The plastic surgeon requires imagination for he must look into the puzzle of cleft. With this picture as transparency in his mind’s eye superimposed over the cleft patient, the surgeon is abetted in the sorting out and fitting together of the pieces of the puzzle [3].”

Fig. 1.

Cover picture of Cleft Craft: The Evolution of Its Surgery.

As Dr. Millard suggested, we craniofacial surgeons are trying repair the defect of the cleft lip patients similar to their original face using surgeon’s imagination.

As written in the journal’s homepage, the scope of Archives of Craniofacial Surgery (ACFS) is any aspect of craniofacial plastic and reconstructive surgery, operative procedures, clinical and laboratory research and case reports. For seeking the normal or original face, I hope ACFS also welcomes anatomical studies of the head and neck and aesthetic procedures for the facial area.


Conflict of interest

No potential conflict of interest relevant to this article was reported.


1. Hori VS. Koan and Kensho in the Rinzai Zen curriculum. In : Heine S, Wright DS, eds. The Koan: texts and contexts in Zen Buddhism Oxford: Oxford University Press; 2000. p. 289.
2. Pine R. The platform sutra: the Zen teaching of Hui-neng Berkeley: Counterpoint Press; 2008.
3. Millard DR. Cleft craft: the evolution of its surgery Boston: Little Brown; 1976.

Article information Continued

Fig. 1.

Cover picture of Cleft Craft: The Evolution of Its Surgery.