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Facial Reconstruction

Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical, trauma to patients. Oral and maxillofacial surgeons are trained, skilled and uniquely qualified to manage and treat both aspects, including emergency care and acute treatment, as well as long-term reconstruction and rehabilitation. Surgeons must consider and understand how the treatment provided will influence the patient’s long-term function and appearance.

The surgeons of COFSC meet and exceed the modern standards. They are on staff at local hospitals and deliver emergency room coverage for the full scope of facial injuries, including the following conditions:

  • Facial lacerations
  • Intra oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose or eye socket)
  • Fractured jaws (upper and lower jaw)

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma, such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work-related injuries. Types of facial trauma can range from injuries of teeth to extremely severe injuries involving the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands and salivary ducts (or outflow channels). Our well-trained oral and maxillofacial surgeons are proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

The specific form of treatment for fractures of facial bones is determined by various factors, including the location and severity of the fracture, and the age and general health of the patient.

Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures, such as wiring the jaws together or the surgical placement of small plates and screws at the involved site. The latter technique, called rigid fixation of a fracture, has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.

The treatment of facial fractures should be designed to affect the patient’s facial appearance as minimally as possible, including making the fewest number of incisions possible. Incisions that are necessary are designed to be small and, whenever possible, placed so that the resultant scar is hidden.

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons are usually involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out.

If a tooth is knocked out, it should be placed in salt water or milk and the patient should get to a dentist or oral surgeon as soon as possible. The sooner the tooth is re-inserted into the dental socket, the better its chances of surviving. Never attempt to wipe the tooth off, since remnants of the ligament that holds the tooth in the jaw are attached and are vital to the success of replanting the tooth.

Other dental specialists may be called upon, such as endodontists who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often very effective replacements for missing teeth.