Maxillofacial (“max-il-lo-facial”) trauma involves injury to the mouth, face and jaws. Most maxillofacial injuries can occur from a sports mishap, motor vehicle accident, on-the-job accident, act of violence or an accident in the home. One of the most common types of serious injury to the face occurs when bones are broken. Fractures (“breaks”) can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets and combinations of these bones. These injuries are all complex since they affect an area of the body that is critical to breathing, eating, speaking and vision and immediate evaluation is recommended.

SIGNS AND SYMPTOMS OF FACIAL FRACTURES
Facial fractures can occur in most any setting therefore prompt recognition is critical. Facial fractures should be suspected any one or more of the signs/symptoms occur:

• Significant facial/jaw swelling and bruising
• Significant facial bleeding (nose or mouth)
• Obvious facial deformity
• Inability to open or close mouth
• Loose or displaced teeth
• Blurred vision/ double vision
• Significant or deep facial laceration

Prevention is crucial. Decreasing the chance of injury can occur by simple use of
automobile seat belts, protective mouth guards, and appropriate masks and helmets for everyone who participates in athletic pursuits at any level.

FACIAL FRACTURE TREATMENT
The principles for treating facial fractures are the same as for a broken arm or leg. The parts of the bone must be lined up (reduced) and held in position long enough to permit them time to heal. This may require six or more weeks depending on the patient's age and he complexity of the fracture(s).

In order to reduce facial fractures it may be necessary to use wiring techniques. In the case of a break in the upper or lower jaw, for example, metal braces may be fastened to the teeth and rubber bands or wires used to hold the jaws together. When facial fractures are complex, extensive and /or involve the upper face (cheek bones, eye sockets, forehead bones) multiple incisions may be necessary to expose the bones. Additionally a combination of wiring or plating techniques may be needed to reduce and stablize the fractures. Patients with few or no teeth may need dentures or specially constructed splints to align and secure the fracture. Often, patients who sustain facial fractures have other medical problems and/or other traumatic injuries. Dr. Stephenson will work to coordinate the necessary treatment of the factures with other treating physicians.

FACIAL FRACTURE RECOVERY
Facial fractures typically heal in about 6 weeks. Weekly monitoring of the healing process is required. There will a moderate of swelling and bruising. This will resolve over several weeks but varies between individuals. Incisions and repaired lacerations should be kept clean with hydrogen peroxide/water mixture twice a day. All incisions and lacerations heal with a scar. The use of use of plastic surgery techniques can minimize the appearance of scars but not eliminate the scars. If the jaws are wired shut a nutritional liquid and pureed diet is required. If plates and screws were used in the treatment the removal of these devices is not necessary at the completion of treatment. Patients that have had their jaws wired closed will require removal of the wires and braces at the completion of their treatment. severe facial factures may require additional surgery (several months later) as a second operation to further restore form and function.

FACIAL FRACTURE/FACIAL TRAUMA REPAIR CREDENTIALS
Credentials matter. Dr. Stephenson is a clinical professor of Surgery at the Atlanta Medical Center where he trains surgical residents on all aspects of plastic surgery including the management and treatment of major maxillofacial trauma. The Atlanta Medical is one of Atlanta’s major trauma centers. Dr. Stephenson is board certified in two important surgical specialties for facial fracture repair facial reconstruction and facial cosmetic surgery. His certifications include the American Board of Oral & Maxillofacial Surgery and the American Board of Plastic Surgery.

Dr. Stephenson will be happy to any questions pertaining to facial fractures or any aspect of plastic surgery. To obtain more information call Signature Plastic Surgery (770) 466-4700.