A facial fracture is a break or crack of any of the bones of the face and skull. These injuries can result from a fall, motor vehicle accident, sports injury, work-related injury, gunshot, or altercation. The bones most commonly affected are those of the nose, cheek bone (zygoma), eye-sockets (orbit), and jaw (mandible and maxilla). These injuries can be a significant source of stress as they can affect your ability to breath, see, eat, or speak. These injuries can also have dramatic effects on facial appearance, particularly fractures affecting the nose and cheekbones. Sometimes there is damage or loss to the skin and soft tissue of the face, resulting in further compromise in facial appearance and function. As in all fractures of the bone, surgical reconstruction of facial fractures should be performed soon after the injury has occurred to optimize healing. Dr. Flores has one of the most extensive experiences in the Midwest with facial fracture repair. He is a frequently invited lecturer to hospitals across the country on the topics of facial fracture repair, and has published many related articles in plastic surgery medical journals.
Broken Nose Repair
A broken nose, or nasal fracture, is the most common type of facial fracture. These injuries are commonly associated with bleeding from the nose, black eyes, and slight displacement of the nose. Sometimes the nose is completely flatted or even telescoped into the head. A broken nose not only affects one’s appearance but the ability to breathe as well. Therefore, it is important to address and restore both form and function when undergoing corrective surgery. If the injury is simple in nature and the deformity is addressed early, a brief “straightening” procedure of the nasal bones and possibly the septum may be all that is needed. More complex nasal fractures or older nasal fractures may require a more formal rhinoplasty to achieve complete correction. One should expect a degree of bruising and swelling to occur after nasal surgery, the degree of which depends on the complexity of surgery. In most cases, the majority of swelling resolves by one to two weeks.
Broken Cheekbone Repair
A broken cheekbone is also known as a malar fracture or zygoma fracture. These injuries can result in bruising around the eye (black eye), numbness in the upper lip, swelling of the eye, a change in facial appearance, and sometimes problems with vision and jaw function. As the cheekbone is closely related to the eye and jaw, a broken cheekbone can affect the function of both structures. Precise reconstruction of the cheekbone is therefore important to not only restore facial structure but also to preserve the function of the eye and jaw. Many patients with cheekbone fractures also have eye socket (orbital) fractures and may require repair of their orbital fracture as well. Patients who require surgery will typically have one or more small incisions placed in the scalp, upper eyelid, lower eyelid, or inside of the mouth, through which the cheekbone is returned to its normal anatomic position. Patients with more complex fractures may require a long incision through the scalp. Often, titanium plates and screws are used to securely fix the cheekbone in its proper position. The incisions used are designed leave a patient with minimal scarring. Swelling typically lasts one to two weeks.
Broken Eye Socket Repair
A broken eye socket, or orbital fracture, is crack or break through one of the “walls” of the eye socket that surrounds the eye. The most commonly affected area is the floor of the eye socket (an orbital floor fracture). Patients with orbital fractures are at risk for double vision, problems with eye movement, and displacement of the eye backwards into the skull or downward into the cheekbone. The floor of the eye socket must be accurately reconstructed to preserve the eye’s function. As the bone of the eye socket is thin, it is usually replaced by synthetic material such as nylon mesh or by bone taken from other parts of the body. Depending on the fracture type or the presence of other fractures, incisions are made within the eyelid and the outside corner of the eyelid, or a single incision is made through a skin crease of the eyelid. The incision within the eyelid will not be visible to others, and the skin crease incision will be barely perceptible at conversation distance.
Broken Jaw Repair
A broken jaw is also known as a mandible or maxillary fracture. These injuries usually result from a high force impact to the face. Patients may not be able to bring their teeth together in a normal fashion. There may also be numbness to the lower lip, teeth may be dislodged, and opening the mouth may be painful. Reconstruction of the jaw is essential to restoring its function. Treatments range from a soft food diet to wiring the jaws together, or placement of titanium plates and screws into the jaw. If plates and screws are required, incisions are made either in the mouth or on the neck, depending on the location of the fracture(s). There is usually a significant degree of swelling associated with these surgeries. Patients will also be given instructions regarding permissible foods and rehabilitative jaw exercises, which are essential in achieving the best reconstructive result.
Late Repair of Facial Injuries
Some patients who have had facial trauma repair still have a degree of facial deformity or problems with vision, nasal function or jaw function. Scars can become problematic in their appearance, there may be bone missing from the face or skull or previously placed hardware can become exposed. In these cases secondary facial reconstruction can be performed to improve the appearance and function of your face. Depending on your needs, these procedures can be simple scar revisions to comprehensive staged facial reconstructions.