Facial trauma can occur after an accident, fall or a physical altercation. Trauma can be further categorized as involving fractures to the bone, injury to soft tissue including lacerations to skin or oral mucosa or trauma to the facial nerves. Dr. Bender performs post-traumatic facial reconstruction in Houston, Texas for the following types of facial fractures:
Bony facial fractures typically require plates, screws, splints or wiring. Soft tissue lacerations typically need a layered suture repair. Primarily, the goal of every repair is to restore or maintain facial function with the use of the best aesthetic approach.
A nasal fracture may require multiple stages for definitive repair. The first stage involves controlling any bleeding or repairing any lacerations and typically occurs in the emergency room. The next stage involves waiting three to five days to allow for external as well as internal swelling of nasal mucosa to start to subside. At this point, the nose can be assessed for fractured nasal bones which can lead to external deformity and difficulty breathing. If a displaced fracture of the nasal bones is present, it is recommended that the fracture undergo reduction which can be performed in the office under local anesthesia depending on patient comfort. It is important to be very careful about applying pressure to the nose with sunglasses or goggles until the bones have time to set which can take around six weeks. There is sometimes an additional stage that occurs around three to six months later if the nose continues to appear crooked or if difficulty breathing remains. In this case, a functional rhinoplasty is needed. This involves a surgical procedure that allows direct access to straighten all of the structures within the nose that are leading to the deviation. This procedure is not always needed but is a possibility should the trauma require more substantial intervention for repair.
Sometimes patients will need to be examined by an ophthalmologist (eye doctor), oral surgeon or dentist to ensure that a comprehensive diagnosis and treatment plan is achieved.
Most lacerations should be closed typically within 24 hours of the injury. If there is concern that there are additional injuries like a broken bone, it is better to get evaluated and treated as soon as possible.
These procedures can be performed in the office, at a hospital, or an outpatient surgical center.
The recovery after reconstructive surgery will depend on the particular case and procedure. Both swelling and bruising are common after surgery but will improve over time.
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