Facial trauma and fracture repair

The face is a complex structure of muscles, bones, nerves, and blood vessels. Facial trauma is any physical injury to this structure, including the jaw, nose, and eye sockets. These injuries can result from accidents, falls, sports, or violent events. Facial trauma and fracture repair treats broken bones (fractures) and soft-tissue injuries to restore function and appearance.

Oral and maxillofacial surgeons, who specialize in managing bones and soft tissues, treat facial trauma and fractures in collaboration with experts in plastic surgery, reconstructive surgery, and ophthalmology. Penn Medicine is a leader in this field, providing advanced care backed by a long tradition of expertise in treating injuries and disorders of the mouth, teeth, jaws, and face.

Facial fractures can be treated through various methods, depending on the severity and complexity of the injury.

• Closed reduction: This nonsurgical approach involves manually repositioning the broken facial bones to bring them into alignment. Your provider physically moves your bones back into place without the need for surgical incisions.
• Open reduction: This surgical procedure is necessary for more complex fractures that can’t be successfully repositioned through manual manipulation. Your surgeon makes an incision to access the fractured area, then carefully repositions the bones to ensure proper alignment.
• Open reduction and internal fixation (ORIF): This technique involves surgically exposing the fractured bone, repositioning it into its correct anatomical position, and then stabilizing it with metal plates and screws to maintain its alignment and promote proper healing.
• Reconstructive surgery: This comprehensive surgical approach addresses severe facial injuries. Its primary goals are to restore essential functions such as vision, chewing, swallowing, and nasal breathing, while also improving overall appearance and correcting facial asymmetry.

Your provider may recommend trauma repair or surgery if you’ve experienced a serious facial injury resulting in:

• Deep cuts or tears
• Broken facial bones
• Changes in your bite or jaw alignment
• Alterations to your facial structure
• Loss of function—breathing, eating, speaking, or seeing
• Facial pain, swelling, or bruising

Every facial trauma case is unique. Less severe injuries, like facial cuts (lacerations), can often be treated with stitches and a local anesthetic. More serious injuries typically require a surgical procedure under general anesthesia, meaning you’ll be asleep during the operation.

Your surgeon will assess the extent of the damage and plan the necessary repairs. This may involve realigning broken bones using specialized hardware like plates and screws and addressing any damage to surrounding soft tissues. Extensive injuries might require transferring tissue, bone, or muscle to the area (grafting), reconnecting or replacing blood vessels, repairing nerves to restore function, or wiring the jaw shut to stabilize it.

Your recovery time depends on the severity of the injury, the type of treatment, and how quickly your body heals. In general, you can expect:

• Swelling and bruising: These side effects will be most noticeable at first but should improve gradually within a few days to a week.
• Pain management: Your doctor may prescribe medication to help manage any discomfort you experience.
• Dietary considerations: You might need to follow a soft food diet for a few days or weeks, depending on the extent of the procedure.
• Ice packs: Applying ice packs to the affected area can help reduce swelling and discomfort.
• Head elevation: Sleeping with your head elevated can minimize swelling.
• Stitches: If stitches were used, they’ll usually be removed after about a week or they may dissolve on their own if absorbable.
• Numbness: Temporary numbness near the surgical site is common and should improve gradually as the nerves recover.

The Department of Oral and Maxillofacial Surgery at Penn Medicine is a pioneer in care, research, and medical training. Our surgeons use advanced techniques, including virtual surgical planning (VSP), to repair facial trauma. This 3D modeling technology improves precision and efficiency in complex cases, often resulting in shorter surgeries and less time under anesthesia.

For facial reconstruction after trauma, our facial plastic and reconstructive surgeons offer the latest advancements in surgery and reconstruction. Our surgeons may also collaborate with ophthalmologists, neurosurgeons, dental experts, and speech pathologists to provide the most comprehensive care to meet your needs.