Facial fracture repair

About the procedure

Facial fractures are very common in the general population. Common bones of the face that are fractured include the nose, mandible (jaw), orbit (eye socket), and zygoma (cheek). Facial fractures can have devastating consequences on both appearance and function, and should be evaluated by someone well versed in facial fracture repair.

Mandible Fractures


There are many different ways that Dr. Hirsch will repair mandible fractures, depending on the location and condition of the fracture. Often, the fractures can best be healed by making a small incision inside the mouth and applying a metal plate which will hold the fracture in place while it heals. Other times, it is necessary to make an incision on the external skin, through which the mandible will be approached and plated. For severely comminuted (multiple pieces) mandible fractures, it may be necessary to use an external fixator or to wire the mouth shut for an extended period of time. Dr. Hirsch will evaluate your mandible fracture and will provide you with a treatment plan at the time of your evaluation.

Orbital Fractures


In general, Dr. Hirsch will repair orbital fractures by returning the contents of the orbit to their normal location and then inserting a plate into the orbital floor to maintain the orbit while it heals. There are different ways to approach the orbital floor- occasionally, Dr. Hirsch will make an incision within the eyelid and will use this approach to visualize the orbital floor and insert a plate. Other times he will make an incision in the external skin of the eyelid and will approach the orbital floor from this direction. If there are existing lacerations in the upper cheek or the eyelid, Dr. Hirsch may use these wound to approach the orbit and fix the fracture.

Zygoma Fractures


Zygoma, or cheek fractures, are complex fractures because of the connections of the zygoma to the many other bones in the face. When the zygoma has been fractures, it may rotate and can therefore be difficult to reconnect to the other facial bones. In order to repair zygoma fractures, Dr. Hirsch may need to make an incision in the mouth, as well as the lower eyelid, and possible the upper eyelid as well. Through these incisions, he will return the bones to their normal positions, and then fix plates to the fractured segments to hold them in position while they heal.

The recovery after facial fracture repair depends a great deal on which procedures were performed. After orbital fractures, there is often significant swelling for 1-2 weeks, which may be accompanied by bruising as well. Occasional blurred vision is common, although if it is persistent it may be necessary to consult an ophthalmologist. After mandible fractures, the jaw is often swollen and tender to touch. Typically, patients will eat a liquid diet for the next 2-4 days following surgery, then gradually advance to a soft diet for the first 4 weeks postoperatively, and then slowly return to their normal diets. Zygoma fractures often have elements of orbital fractures with a similar recovery period, and require a soft diet for the first 4 weeks postoperatively due to the intraoral incisions. With all facial fractures, it is critical to apply ice to the fracture site to reduce swelling and post-operative discomfort.

Frequently asked questions about facial fracture repair:

Will I need my jaw wired shut after my mandible fracture repair?


Some patients will need their jaws wires shut after mandible fracture repair, depending on the fracture pattern. Every patient is different, and Dr. Hirsch will evaluate your mandible fracture and design a treatment pattern that works for you at the time of your consultation.

Additional resources about facial fracture repair


Feel free to browse the following links to learn more about facial fractures including mandible fractures, nasal fractures, zygoma fractures, and orbital fractures.

https://www2.aofoundation.org/wps/portal/surgery?showPage=diagnosis&bone=CMF&segment=Overview



Dr. Elliot Hirsch

Meet Dr. Elliot Hirsch

Los Angeles plastic surgeon Dr. Elliot M. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University. He is an active researcher and has published over 40 original papers and book chapters, and holds patents for his inventions in plastic surgery. Dr. Hirsch’s specialties include not only aesthetic surgery, but reconstructive surgery with special attention to aesthetic detail to ensure that patients achieve the best possible results.

To read more about Dr. Hirsch, please visit his extended biography page.


Read Dr. Hirsch's Biography