Facial Trauma

Call 911 for a facial injury with difficulty breathing, heavy bleeding, loss of consciousness, a change in vision, or clear fluid draining from the nose or ears. These need emergency care first.

• Nasal fractures. A broken nose is the most common facial fracture. It can cause swelling, a change in the shape of the nose, nosebleeds, and difficulty breathing through one or both sides.
• Cheekbone and eye socket fractures. These can cause flattening of the cheek, numbness of the cheek or upper lip, double vision, or a change in the position of the eye.
• Jaw fractures. These can cause pain when chewing, a change in how the teeth fit together, or difficulty opening the mouth.
• Soft tissue injuries. Cuts and lacerations of the face, lips, and eyelids may affect the nerves, glands, or ducts beneath the skin as well as the skin itself.

Some effects of a facial injury become clear only after the swelling goes down or the wounds heal:

• Nasal blockage or a change in the shape of the nose
• Numbness or altered sensation in part of the face
• Scars that are raised, wide, or pull on nearby features. See Scar Revision.
• Hearing changes, ringing in the ears, or balance problems when the injury also involved the head. See Hearing & Tinnitus and Balance Problems and Vertigo.

The evaluation starts with a history of the injury and your symptoms since. Dr. Kayem examines the face, nose, eye movements, bite, and sensation. Imaging, most often a CT scan, shows the facial bones in detail and is commonly used to assess fractures. Depending on the findings, you may be referred for an eye or dental evaluation.

Treatment depends on the type of injury and on how much time has passed since it happened:

• Fractures may be set back into position without incisions (closed reduction) or repaired surgically (open reduction), depending on the fracture.
• Soft tissue injuries are repaired with attention to the layers beneath the skin.
• Later effects, such as nasal blockage or scarring, may be treated once healing is complete. See Nose Surgery and Scar Revision.