What is a facial fracture?
A facial fracture is a break in one or more of the bones in your face. These bones include those around your eyes, cheekbones, and those of your nose and jaw.
What causes a facial fracture?
Most facial fractures occur due to a substantial amount of force to the face typically as a result of trauma or injury to the face. Traffic accidents, sporting injuries, falling, and assault account for the majority of facial fractures.
Definitive treatment for most facial fractures requires advanced reconstructive surgical skills and special equipment.
How is a facial fracture diagnosed?
Facial fractures are generally easily detectable and diagnosed. A variety of tests can be performed in order to properly diagnose the specific type and location of fractures present.
- CT scan
- An x-ray machine uses a computer to take pictures of your head. These pictures will show any broken bones and damaged tissues.
- An ultrasound uses sound waves to show pictures on a monitor. It has the ability to show damage to both facial bones as well as tissues.
- A facial X-ray takes a picture of the bones in your face. This test aids in finding broken bones as well as foreign objects, infections, and other changes in bone structure.
Types of facial fractures:
Injury and trauma to the face can result in facial fractures. Symptoms are specific to the type of injury present but typically involve pain, swelling, loss of function, or changes of facial structures.
- Nasal Fracture
- Fracturing the nose is a common injury resulting in a painful, swollen face. Although many nose fractures can heal quickly with a slight adjustment and/or stabilization, others require a more advanced facial reconstructive surgery.
- Due to extreme swelling caused by a nasal fracture, a broken nose is not immediately put back into place. After the swelling lessens, repairing and repositioning is necessary if you are experiencing a poor cosmetic result such as a crooked nose or a loss in functionality, such as blocked airways and impacted sinus cavities.
- Maxillary Fracture
- Fractures in the mandible area can result in serious problems such as severe swelling and even lead to deformity of the face.
- Maxillary fractures require surgery if they present problems such as a change in dental occlusion, limitation of jaw opening, sunken eyes, change in vision, or facial numbness.
- The goal of maxillary fracture reconstructive surgery is to restore the normal contour of the facial anatomy and ensure the patient’s jaw is physiologically as normal as possible. There are many possible techniques in order to fix the fracture, but once the broken bones are put back into place and stabilized, plates and screws can be used to keep the bones in place.
- Zygomatic Fracture
- Usually, cheekbone fractures are an isolated injury that display mainly cosmetic problems. Zygomatic fractures can present problems such as flatness of the cheeks, altered vision, or pain with jaw movement. However, in unusual instances nerve function can be altered due to a zygomatic fracture.
- The treatment of reconstructive surgery for zygomatic fractures includes the restoration and repair of normal facial features and normal sensory nerve function.
- Orbital Fracture
- An orbital fracture is a traumatic injury as a result of blunt force trauma to the eye. Symptoms that occur with orbital fractures include blurry or decreased vision, bruised eyes, swelling of the forehead or cheeks, flattened cheeks, pain of the eye, facial numbness, or blood in the sclera.
- Orbital fractures require surgery when the fracture impedes eye movement, vision is compromised, or the eyeball has sunken into the socket.
- To surgically correct the the fracture, the broken bones are moved back into their normal position and may be supported with hardware if necessary.
Facial Fracture FAQ:
What causes a facial fracture?
A facial fracture results from injury or trauma occurring directly to the face. Car accidents, sporting injuries, or physical attacks are all possible injuries that can result facial fractures.
What are signs or symptoms of a facial fracture?
Although symptoms vary based off of the location of the facial fracture, common symptoms include blurry vision, seeing floaters, decreased or painful eye movements, sunken eyes, swelling of the face, numbness of the face, or swollen or flattened cheeks.
What can I do to help my healing following surgery?
Applying ice, keeping your head elevated and avoiding pressure on your face are all important things to remember while recovering from a facial fracture surgery. Both icing and keeping your head elevated will help decrease the swelling and pain. Avoiding putting pressure on your face is important to help the fracture heal. Dr. Sufyan advises patients to avoid sleeping on the injured side to prevent further damage. It is also recommended to sneeze with your mouth open if possible and avoid blowing your nose. The pressure from a sneeze or blowing your nose can impair proper healing.
What should I expect postoperatively?
Although there is usually no excessive pain after surgery, some pain may be present. This is typically controlled with prescription pain medication. Bruising and swelling is very normal because of the trauma your face has been through. Most swelling will begin to fade within the first week and continue to dissipate increasingly after that.
How long will I be out of work following a facial fracture surgery?
Rest and relaxation are strongly advised during the first week following surgery in order to speed up recovery and minimize both bruising and swelling. Because everyone recovers at a different pace, there is no specific recovery time for a facial fracture surgery. However, most patients with sedentary jobs may safely return back to work 2-3 weeks following surgery. Those whose jobs require physical exertion may need an additional week or two before returning to work.
In every case, it is recommended to avoid unnecessary exertion for at least one month after surgery to avoid prolonged swelling.
Why does my face feel odd after my surgery?
Because of the severe trauma to your face, your tissues, skin, and bones are likely bruised, swollen, and injured. This is commonly the reason for an altered sensation of the face or facial numbness following surgery. Depending on the extent of your injury, this feeling may take weeks to fully disappear.
When will I be able to see results?
Results will start to be visible after the swelling and bruising have subsided. Because all individuals are unique, this time period varies. Final results are able to be seen approximately 2-3 months post operatively.
Does a facial fracture surgery require an overnight hospital stay?
Rarely. This procedure can be performed in the hospital or in an outpatient surgical center. You will most likely be able to go home a few hours after your surgery.
Are there any medications that need to be avoided before surgery?
It is important to avoid taking certain medications, vitamins, and herbs two week prior to your surgery. This is because some medications may cause you to bleed more than normal and therefore increase bruising and swelling post-operatively.
Will insurance cover a facial fracture reconstructive surgery?
It is important to understand that cosmetic surgery is typically not covered under most insurance plans. But because most insurance companies cover that which is medically necessary, most insurance companies will cover facial fracture procedures caused by injury or trauma. Coverage will depend on your insurance carrier.