Reconstructive surgery is performed on abnormal structures on the neck, face, and head. In most cases, these abnormalities are caused by disease, birth defects, infection, trauma, and injury. This type of procedure is typically performed to improve function. However, reconstructive surgery is also useful for improving the quality of life by repairing the function that has been affected as well as restoring a normal appearance.
Patients who require reconstructive surgery to correct fractures or lacerations caused by accidents, animal bites, athletic injury, and other forms of trauma. It is important to note that traumatic facial fractures commonly involve the brow, eye socket, jawbone, and cheekbone. Reconstructive surgery realigns the bone segments and improves fixation for successful healing.
The timing of fracture repair and facial surgery is vital to the success of the procedure. Facial bones and tissues tend to heal quickly. As a result, these areas require medical attention immediately. In most cases, a board-certified reconstructive surgeon is required to ensure safety. These surgeons receive intensive training and must pass a certification process approved by the ABPS.
Severe facial lacerations and trauma can cause ear avulsion, scarring, tear duct injury, and nerve damage. Patients who experience these types of traumatic lacerations may require specialized attention with advanced techniques.
Injury or trauma to the face can damage the skin and bone structure. Some patients require surgery to improve nasal bones and the septum. When the nose or septum is fractured, this can affect the skeleton which provides support for the eyes and teeth. Some facial injuries are minor and as a result, do not require invasive treatment. However, patients must receive surgical treatment in order to repair soft tissues or damaged structures.
When the facial fracture is severe, plastic surgeons may make incisions and perform specific surgical techniques to repair the fracture. In some cases, this may require using screws, wires, and plates to fixate bones. Although facial fractures and abnormalities may be painful and difficult to cope with, treatment is necessary and time is of the essence to correct the functionality that has been affected by a potential trauma or injury. The surgery may also enhance the patient’s appearance after primarily addressing the underlying cause of concern.
A broken nose is the most common facial fracture and needs to be treated quickly. Depending on the extent of injury, a rhinopasty may also be needed to shape the nose aesthetically. An otolaryngologist can treat the nose if seen within two weeks of the injury. If the injury is older than two weeks, a reconstructive plastic surgeon will have to work on the nose. In this case, the surgeon will wait two or three months for the swelling to go down, and will then straighten and reposition the nose, restoring the patient’s appearance and breathing to normal.
A person with a facial fracture is considered a good candidate for reconstructive surgery if the fracture causes a deformity and/or interferes with function. A broken nose, for instance, can interfere with breathing. Other criteria indicating a need for surgery are double vision and a change in occlusion (the way the teeth come together). Jaw fractures always require surgery because they do interfere with function (chewing, speaking, etc.) and the jaw is a moving part, which means it has to be immobilized in order to heal.
Severe facial fractures like mid-facial injuries require immediate treatment, while milder ones do not. Since the skull acts as a natural cast and thereby keeps the fractured bone immobilized, minor fractures can be treated at home.
A patient seeking reconstructive surgery should make certain that their surgeon is board-certified. Any doctor will have a medical license allowing them to practice, but a board-certified doctor has earned certification from one of 24 boards devoted to a specialty. A doctor seeking certification has to take an oral exam and a written exam pertaining to their specialty. In addition, they have to learn the best and newest practices of their chosen field to keep their certification.
Facial fractures, or broken bones in the face, are almost always the result of trauma such as automobile accidents, falls, sports injuries and assaults like domestic violence. The face is vulnerable to several different types of fractures. These include orbital fractures, which involve the bones surrounding the eye, cheek bone fractures, jaw fractures, forehead fractures and nose fractures. Broken bones in the face are diagnosed with an ultrasound, x-ray, or CT scan.
Facial fractures can cause distortions in both appearance and function. Someone with fractured nasal bones, for instance, might experience a crooked nose as well as an airway obstruction. Reconstructive surgery can help treat both types of problems. Whether your facial fracture is causing problems in functioning or is purely cosmetic, it is worth consulting with a board-certified cosmetic surgeon to see how you can be helped.
Depending on whether or not the fracture breaks the skin, the fracture can be open or closed, both of which can be life-threatening and require medical treatment. Other risk factors and/or complications that arise include:
young children or the elderly
playing sports without proper protection
and health conditions
The open reduction and internal fixation or ORIF involves reaching the broken bones through small incisions and using micro wires, screws and plates to hold the bones in place while they heal. Another type of surgery involves removing damaged bone and replacing it with a graft from a healthy bone. Ideally, both types of surgical procedures restore normal appearance and functioning.
Reconstructive facial surgery may be primary, occurring immediately after the injury, or secondary, occurring weeks to months later. Secondary surgeries may involve re-breaking and re-setting bones that have not healed properly. Because facial fractures are often accompanied by other injuries such as damage to the teeth or eyes or trauma to the brain, a reconstructive plastic surgeon often works closely with other specialists to determine the best time for treatment.
Reconstructive surgery can improve various conditions. For instance, the mandible or jawline can be repaired around 7-10 days after the surgery, in order to fix the teeth to its natural positions as best as possible. Mid-face (or maxilliary) surgery can shape the face’s skeletal contour and improve the jaw or bite functions while nasoethmoid complex fractures can create the proper distance between the spaces of the sinus bones.
In addition, for both upper and lower jaw, nose, zygoma (or cheek bones), and bones in the eye or forehead, maxillofacial surgery involves treating the bones and facial soft tissue structures that has a double reconstructive (when referring to treatment of traumatic injuries) and aesthetic or cosmetic value for items like chin, cheek, or facial bone recontouring. As a result, maxillofacial surgery can be performed within days of the injury, with secondary surgeries completed within weeks, months or years of the injury in order to accommodate the natural results of healing.
Being involved in an incident that results in facial fractures is usually both physically and emotionally traumatic. You can ensure that you receive the best care by consulting a board-certified cosmetic surgeon to learn about your treatment options. A qualified reconstructive plastic surgeon, can restore your appearance and help you recover.
When people think of plastic surgery, they may think of nose jobs, lip augmentations, or cheek lifts. However, for many patients, reconstructive plastic surgery is a life changing procedure. Some candidates for reconstructive surgery were involved in some kind of traumatic incident that resulted in facial fractures. Car accidents, sports injuries and assaults are just a few examples of causes of facial fractures. After recovering from these incidents, people are often left trying to rebuild their self-esteem and lives. Facial fractures can be just as debilitating as the traumatic incident itself. Facial reconstructive surgery can repair the fracture and give patients their confidence back.
Many patients find facial reconstructive surgery to be their solution and source of relief in treating facial fractures. Some major facial fractures can result in impaired vision, trouble breathing through the nose, airway obstruction, or painful chewing.
A cosmetic and reconstructive surgeon can determine what must be done to properly reform your facial features and realign the facial bones, to hide the incisions and minimize scarring. Steel plates and rods may be necessary to reconstruct the bones.
If you suffer from a facial fracture, do not ignore it or wait to repair the fracture, especially if it is affecting your normal bodily functions and health. If you sustained a severe facial fracture, you may need immediate treatment and perhaps need to visit an emergency room. If your fracture is not life threatening or as severe, schedule an appointment at our office and meet with a board certified cosmetic surgeon to repair the fracture.
Facial fractures are unfortunate, unexpected, and can happen to anyone. Any major facial impact or trauma can cause broken bones in the face, including motor vehicle accidents, sporting injuries, falls, and violent wounds and stabbings; in addition, depending on the area(s) affected, its symptoms range from pain, swelling, nosebleed and deformity for a broken nose, tenderness in the jaw, and visual problems for maxillary (or midface) fractures.
As always, it is wise to consult each of these surgery options with a board-certified reconstructive surgeon attending to these specific needs and help optimize the value of surgery in order to regain its function and repair its appearance.
