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Frequently asked questions about facial fractures

What are facial fractures?

Facial fractures are fractures (broken bones) of the face and mouth. They commonly include fractures of the nose (nasal), cheekbones (zygoma), surrounds to the eyes (orbit) and upper (maxilla) and lower (mandible) jaws.

If you have a facial fracture, the oral and maxillofacial team will usually want to check that you don't have other fractures of or injuries to the head or neck and if you have been knocked unconscious.

What causes facial fractures?

Most facial fractures are acute (sudden) and caused by assaults (eg fighting), sports (eg horse riding, football and rugby) and accidents (eg road traffic or falls). Rarely, you might get a fracture following other treatment - sometimes this is because the bones are weakened by conditions such as dental cysts.

How will I know if I have a facial fracture?

If you have had some kind of blunt or sharp trauma to your face, your doctor(s) or dentist(s) will want to check you for facial and other fractures. They will examine you carefully (looking for changes in mobility, swelling and pain) but will also send you for X-rays. Most fractures show up clearly (as dark lines) on head, facial, jaw and dental X-rays. Some small (hairline) fractures are more difficult to see and require further X-rays and followups.

What are treatments for facial fracture?

The treatment options that you will be offered will depend on the type and extent of the fracture and any other problems you might have at the time.

In general, doctors will want to bring the broken bones back into a normal alignment (called 'reducing' the fracture) and keep it/them in this place (called 'fixing the fracture'), preventing further injury. Sometimes they will need to operate to do this. Sometimes they will need to use plates, screws or wires (or other fixation) inside or occasionally outside the bones to hold the fractures in place.

Your oral and maxillofacial surgeon will explain more about your fracture(s) and its treatment.

I have a facial fracture, how long will it take to heal?

How long it takes a facial fracture to heal will depend on the type and extent of fracture and what other problems and treatment you had. Bruising and swelling usually takes 2 to 3 weeks to settle down. At this point, you will begin to look more normal. After this time the body will continue to heal itself inside. Unfortunately, you will need to be a patient.

My face is numb or feels odd, after a facial injury, how long will this take to heal?

The facial bones have many channels in them in which small nerves run. These nerves are sensory nerves (sensing hot, cold, touch, pain etc). When the nerves emerge from the bones they distribute themselves through the soft tissues and skin of the face.

When you have had a facial injury (including a fracture) your soft tissues, skin and the bones are likely to be bruised, swollen and damaged. This can lead to short-term pain but also numbness or altered sensation to the face. Depending on the position and extent of injury, this change in sensation often takes a number of weeks or maybe even months to disappear completely. Very occasionally, only partial or no recovery occurs.

Motor nerves tell muscles how and when to move. They run between the facial bones and the skin and can be injured by trauma.

What are plates used to treat facial fractures?

The plates used to repair facial fractures are made of titanium. They hold together and strengthen the bones of your face, head (or skull) and/or jaws.

Will I have to have the plates removed?

The plates used to repair facial fractures are designed to be left in place and stay with your bone permanently. Very occasionally, they might need to be removed later for example if they cause an infection or discomfort.

Will the plates set off metal detectors at airports?

Because the plates are made of titanium, they do not set off the metal detectors used at airports.

Do I need to tell anyone that I have a metal plate in my face/jaws?

It is wise to mention your metal plate if you need to have scans such as computerised tomography (CT) or magnetic resonance imaging (MRI).

Why have I been told that I shouldn't blow my nose for the next few days?

If you have a fracture of the cheek bone, you should not blow your nose for about ten days following the injury. This is because you might force air from your sinuses into the skin, which can result in facial swelling around the eyes.

This swelling is temporary and will disappear with time. If you have any questions, you should seek advice from your oral and maxillofacial surgeon.

If I have had a facial fracture, what other things should I avoid for the next few weeks?

If you have had a facial fracture, you will be advised by your oral and maxillofacial team to avoid knocks or bumps to the area for at least 6-8 weeks until the fracture has healed. This is because 'impacts' on fractured areas might move the affected bones.

For how long should I take my antibiotics?

Often we will prescribe a course of antibiotics for people who have had a facial fracture or other procedure to the mouth or face. This is to prevent an infection.

Whenever you are prescribed antibiotics, it is important to finish the course as instructed. This is for your health and also to prevent the emergence of antibiotic resistance in the general population.

If you have any problems taking the antibiotics (eg side effects), do contact your general practitioner (GP) or the oral and maxillofacial team that treated your injury or performed the procedure.