Reconstructive Procedures: Skeletal and Soft Tissue Trauma

Facial fractures occur when any part of the bony skeleton of the face is broken. This can occur in the upper, middle, or lower face, and can be simple (single fracture line) or comminuted (multiple fracture lines). In high energy injuries to the face, multiple parts of the facial skeleton can be fractured, leading to a complex fracture configuration. Fractures can also be classified as open or closed fractures, depending on whether the fracture is associated with an overlying wound.

If the fracture occurs close to vital structures such as the eye or teeth, it can lead to compromise of function such as double vision for the former or problems with biting in the latter. In some of these cases, such as an impingement of the eyeball or eye muscle, the fracture has to be fixed expediently.

Through their extensive training in facial anatomy and keenly developed tissue management principles, plastic surgeons are well equipped to handle all forms of facial fractures and soft tissue trauma, restoring proper symmetry and contours of the facial skeleton whilst delicately handling the skin, muscles, and other soft tissues to minimize or camouflage scarring.

Your plastic surgeon should conduct a thorough assessment of your facial injury, and may order further imaging such as fine-cut CT scans of the face to further delineate its extent, and to aid in planning of repair. They will then recommend the most appropriate route of repair, optimizing return of function and minimizing scars. Oftentimes, facial fractures can be repaired without any external scars via the transconjunctival (lower eyelid) or buccal sulcus (intra-oral) routes.

In complex facial injuries, plastic surgeons can coordinate management with other specialties such as neurosurgery, ENT surgery, ophthalmologists, as well as dental surgeons, to achieve the optimal return of form, function, and dental occlusion. In addition to this, our plastic surgeon is trained in computer-aided planning which may be required for precise restoration in a case of complex or multiple facial fractures.