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Facial fractures are breaks in the bones of the face: the nasal bones, cheekbone (zygoma), eye socket (orbit), upper jaw (maxilla, classified as Le Fort patterns), lower jaw (mandible) and the frontal sinus. The nose is broken most often, followed by the lower jaw and cheekbone. These bones shape your appearance and also support the eyes, airway, bite and sinuses.

Undisplaced fractures often heal without an operation. Displaced fractures are repositioned and held with small titanium plates and screws, ideally within about 2 weeks, before the bones set in the wrong place. Early repair gives the most natural result. Late correction of a healed deformity is possible but more complex, and numbness from bruised facial nerves may be slow to recover or permanent.

Symptoms

• Swelling, bruising and tenderness of the face
• Black eyes or bruising behind the ear
• A flattened cheek or crooked nose
• Teeth that no longer meet properly, or difficulty opening the mouth
• Numbness of the cheek, upper lip, upper teeth or lower lip
• Double vision or pain on looking up, or a sunken eye
• Nosebleed or clear watery fluid running from the nose
• A step felt along the jawline or eye socket rim

Causes and risk factors

The usual causes are assaults, road traffic accidents, falls, sports injuries and workplace accidents. In older people a simple fall is the commonest reason. High-energy facial trauma is frequently accompanied by head injury, neck injury and eye injury, which take priority in the emergency department. Not wearing a seat belt or helmet increases both the chance and the severity of these fractures.

How it is diagnosed

• Emergency assessment: Airway, bleeding, the cervical spine and brain injury are dealt with before the facial bones.
• Examination of face, bite and nerves: The surgeon checks symmetry, bony steps, mouth opening, how the teeth meet, skin sensation and facial movement.
• CT scan with 3D reconstruction: The standard imaging test; it shows every fracture line and the orbital floor in detail.
• Eye examination: Vision, pupils, eye movements and eye pressure are checked in any fracture around the orbit.
• Dental panoramic X-ray: Useful for lower jaw fractures and teeth in the fracture line.

Treatment options

• Observation and soft diet: For undisplaced fractures, with advice not to blow the nose after orbital or sinus fractures and a review at 1 to 2 weeks.
• Closed reduction: Manipulation of nasal bones or a depressed cheekbone arch without plates, usually within 2 weeks.
• Open reduction and internal fixation: Titanium miniplates placed through hidden incisions inside the mouth, the lower eyelid or the hairline.
• Orbital floor reconstruction: A thin mesh or implant supports the eye when there is persistent double vision or a large defect.
• Jaw fixation: Plates, sometimes with a period of elastic or wire fixation between the teeth, to restore the bite.
• Secondary correction: Osteotomies, custom implants, bone grafts, rhinoplasty and scar revision for healed deformity or asymmetry.

When it is urgent

All significant facial injuries need emergency care locally. Call an ambulance for difficulty breathing, heavy bleeding, loss of consciousness, neck pain, any loss of vision, or a bulging, tense, painful eye. A child who develops nausea and pain on looking up after a blow near the eye may have a trapped eye muscle, which needs surgery within hours.

Travelling to Türkiye for treatment

Fresh fractures should be treated where the injury happened; the window for straightforward repair is roughly 2 weeks, and flying with orbital or sinus fractures should be cleared by a doctor first. Travel is relevant for late problems: residual asymmetry, a sunken eye, a bite that is off, or a crooked nose after healing. These are planned reconstructions, usually needing 7 to 14 days on site. Bring your original CT scans and operation notes.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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