Any trauma to the face that results in fracture is likely to require a long and complicated reconstructive procedure. The structure of the face is incredibly complex, and the reconstructive surgeries that correspond to the various areas of the face are at least as many and as intricate. Facial traumas resulting in fracture include subcondylar fractures of the mandible, orbital blowout fractures (OBFs), frontal sinus fractures, and zygomatic fractures, to name a few.
Surgical techniques used to treat these injuries may include endoscopy, maxillofacial or orthognathic surgery, microsurgery and bone grafting. If the patient presents a facial fracture, they typically present damage to other tissues as well. Because of this, flap surgery, tissue expansion, and skin grafts may be used during reconstruction.
When Do Facial Fractures Need Reconstructive Surgery?
As in other parts of the body, facial fractures occur when a traumatic blow breaks a bone in the face. Some breaks, like nasal fractures, do not require surgery. Surgery is most often necessary when the break impairs appearance, and more importantly, function of the injured area or area adjacent to the break.
What to Expect During Surgery
First, x-rays or computed tomography (CT) scans will be taken so that Dr. Neal Goldberg, our highly trained plastic and reconstructive surgeon, can better analyze the fractures and the degree of trauma to the surrounding areas. The surgery itself can take as little as a couple to more than ten hours, and multiple surgeries may be required. In most instances, general anesthesia will be used.
In order to repair the broken bone(s), bone grafts may be taken from other parts of the patient’s body like the skull, pelvis, or ribs. If the bone is crushed, or only small pieces are missing, the surgeon may use hydroxyapatite cement, or polymer implants to repair the area. Special fixation devices composed of titanium plates and screws may also be applied in order to fortify the repair.
When large areas of skin are missing, Dr. Goldberg will perform flap surgery, transferring tissue along with its blood supply from one area of the patient’s body to the wound area. Microsurgery may be used to anastomose blood vessels.
Some facial injuries may require the assistance of a neurosurgeon, oral surgeon, or ophthalmologist.
Depending on the extent of the operation, you may need to remain in the hospital for monitoring for a day or two following surgery. Once you are released from the hospital, you will be instructed on how to take care of your dressings, and how to administer medication. Follow-up appointments to gauge the your healing process may be recommended.
For more information about facial reconstructive surgery, call our office for a complimentary consultation at 914-722-1600.