FACIAL INJURY AND RECONSTRUCTION

“Having a facial injury can be extremely emotionally traumatic as well as physically painful. Your face is an important part of your identity. Any trauma to the face, even those that will heal completely within weeks, can still look very alarming so one of my major goals is to reassure patients as much as possible right from the start.“


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As well as coping with the way your face looks, you may also have to overcome some debilitating physical effects. Swelling and bruising to the eyes, mouth and jaw can prevent you seeing, eating and speaking normally. Many people are scared they will have permanent scarring or a facial deformity once the tissues have healed. Fortunately, we expert help and patience, many patients are relieved to find their appearance slowly returns to normal.

Mr Hodges has a wealth of experience in treating facial injuries and in facial reconstruction, which means he is well-placed to guide you through the treatment process. When you come in for a consultation after suffering a facial injury, he will assess which structures have been damaged, the extent of the damage, and which functions have been affected by the injury. Usually X-rays or scans are also required to help diagnose the pattern of injury.

Once all the examinations and tests have been completed, Mr Hodges will sit down with you to discuss treatment options, explaining each one carefully and answering your questions..

Mr Hodges specialises in treating facial trauma using cutting edge techniques so that you can have the best cosmetic result as well as the best recovery of function.

“When I plan any  facial reconstruction after injury my goal is to repair the injuries very sensitively. I am able to use my cosmetic surgery training in additional to my maxillofacial surgery training to give you the best aesthetic outcome. This involves many techniques, including placing scars in the mouth, in skin creases, or within the hairline,” explains Mr Hodges.

Broken facial bones

Breaking a bone in your face is less common than breaking an arm or a wrist, for example, but it can happen. Broken facial bones can be the result of a traffic accident, a serious fall, playing contact sports and suffering violence.

The face actually has many different bones that can break, including the lower jaw (mandible), the upper jaw (maxilla), the cheek bone (zygoma), the eye socket, the nose and the forehead (frontal) bone.

These may be broken either individually, or often within well-known patterns of injury, for example, a cheekbone injury will often also involve the eye socket.

The signs of broken facial bones include:

  • Swelling
  • Bruising
  • Pain
  • Numbness or tingling
  • Double-vision
  • Pain on moving your eyes
  • Pain on opening your mouth
  • Pain on biting
  • Malocclusion (a different bite to normal)
  • Obvious deformity
  • Asymmetry of the face
  • Bleeding
  • Bleeding from the nose

Getting a diagnosis

If you have injured your face and are concerned that you may have broken a bone, it is important to get it checked out as soon as possible as the bones can heal in the wrong position if not corrected. This can make treatment more complicated and can cause cosmetic and/or functional problems in the long term.

Treating broken facial bones

Treating a broken facial bone involves many of the same principles used to treat any other bone fracture:

  • The fracture must first be repositioned correctly so that the broken bones realign.
  • The fracture needs to be immobilised while it can heal.
  • Once healing has taken place, full function should be restored.

Soft tissue injuries

Your face contains many different soft tissues that can be injured including the skin, nerves, blood vessels, muscles and salivary glands. Soft tissue injuries to the face can be caused by blunt or sharp trauma. Signs of soft tissue injury depend on the soft tissue involved:

  • Blood vessel injuries – these cause a wide range of symptoms ranging from bruising to spurting arterial bleeding (the latter needs emergency and immediate care at the time of injury).
  • Nerve injuries – damage to sensory nerves can cause tingling or numbness. It is common, for example, to experience a numb feeling in your forehead after a deep cut to the eyebrow. Damage to motor nerves can cause muscle weakness that can lead to  facial palsy – a lopsided smile or not being to close one eye.
  • Skin injuries – these are usually fairly obvious, such as grazes, cuts, or loss of tissue such as might occur due to a bite or a knife injury.
  • Muscle injuries – the head and neck region has many muscles and these commonly become bruised during trauma and cause swelling and pain with movement. The good news is that muscles have a good blood supply and therefore heal very well.
  • Salivary glands – You have three pairs of major salivary glands inside the tissue on the inside of your mouth. If the glands themselves or the ducts that carry saliva from the glands to the mouth are ruptured or severed, leakage of saliva can occur. This will not heal by itself and usually surgery is needed to explore the full extent of the injury and to repair the ducts as necessary.

Treating facial injuries

The treatment of these injuries include, simple advice such as rest and painkillers, an operation to clean and repair the injury or more extensive reconstruction of the area affected. The good news is that facial wounds heal very well, scars usually fade and function and appearance improve over time.