Facial Trauma Surgery: A Complete Patient Guide

How Treatment Works

Every jaw repair starts from the same principle: restore the bite first. Your teeth fit together in exactly one way, and that fit — the occlusion — is the blueprint that tells the surgeon precisely where the broken bone belongs. Before fixing any jaw fracture, the teeth are guided back into their original bite, and the bone is repaired around that position. Dr. Calleja uses in-office 3D CBCT imaging to map fracture lines in detail before treatment.

Displaced fractures are most often treated with open reduction and internal fixation, or ORIF: the bone is repositioned through incisions usually hidden inside the mouth, then held with small titanium plates and screws while it heals. Rigid fixation is the reason most patients today do not need their jaw wired shut. Some fractures — certain patterns, or patients who are not candidates for plating — are instead treated with maxillomandibular fixation (MMF), where the upper and lower teeth are wired or banded together for roughly four to six weeks so the jaw heals in the correct bite.

Eye socket injuries follow their own rules. An orbital blowout fracture may need repair with a thin implant that rebuilds the orbital floor, and any injury near the eye gets a prompt vision assessment — double vision, an eye that will not move fully, or a sunken-appearing eye are signs that need evaluation without delay.

A knocked-out adult tooth is a true minute-by-minute emergency. The best outcomes come from replanting the tooth within 30 to 60 minutes:

• ✦Pick the tooth up by the crown (the white chewing part) — never touch or scrub the root
• ✦If it is dirty, rinse it briefly and gently with milk or saline; do not wipe it
• ✦If you can, place it back into its socket right away and bite gently on gauze or a clean cloth to hold it
• ✦If you cannot replant it, store it in cold milk — not water — or tucked inside the cheek, and get to us or an emergency room immediately
• ✦Baby teeth are not replanted; a child with a knocked-out baby tooth still needs an exam to check the developing adult tooth underneath

Risks and Safety

Facial trauma surgery is safe and routine in trained hands, but the injuries themselves carry risks, and honest information helps you watch for the right things. Infection is the most common complication of jaw fractures — especially fractures that run through tooth-bearing bone, since those are open to the mouth. Antibiotics, good oral hygiene, and sometimes removing a badly damaged tooth in the fracture line all lower that risk.

If a displaced fracture heals in the wrong position (called a malunion), or fails to heal (a nonunion), the result can be a bite that no longer fits, facial asymmetry, or chronic pain — and fixing it later is a bigger operation than fixing it right the first time. This is the strongest argument for timely treatment. Numbness is also common: the nerves that supply feeling to the lower lip, chin, and cheek run through the very bones that break, so temporary numbness after a jaw or cheekbone fracture is expected and usually improves over weeks to months, though a small number of patients keep some altered feeling.

Eye socket fractures deserve special respect. Trapped eye muscles, worsening double vision, decreasing vision, or severe pain and pressure behind the eye need urgent care — bleeding behind the eye (a retrobulbar hemorrhage) is rare but is a true emergency. Any orbital injury is evaluated promptly, and we coordinate with ophthalmology whenever the eye itself may be involved.

• ✦Infection — the most common jaw-fracture complication; reduced with antibiotics, hygiene, and follow-up
• ✦Malunion or nonunion — bone healing crooked or not healing; prevented by accurate, timely fixation
• ✦Temporary (occasionally lasting) numbness of the lip, chin, or cheek from bruised sensory nerves
• ✦Vision problems with eye-socket fractures — double vision or vision changes need prompt evaluation
• ✦Hardware irritation — titanium plates are designed to stay for life, but occasionally one is removed later in a minor procedure

Recovery and Aftercare

Facial bones take about six weeks to knit together firmly, and they reach full strength over the months after that. During the first several weeks, the repaired bone must be protected from chewing forces: expect a liquid diet at first, advancing to soft, no-chew foods — scrambled eggs, pasta, mashed potatoes, smoothies — until Dr. Calleja clears each stage at your follow-up visits. If your jaw is banded or wired, the liquid phase lasts until fixation is released, and we will walk you through getting enough calories and protein through it.

Swelling and bruising peak in the first two to three days and fade over one to two weeks. Most patients with desk jobs return to work or school within one to two weeks depending on the injury; physically demanding work takes longer. Contact sports and anything with a real risk of another blow to the face wait until the bone has fully healed — typically a minimum of six weeks, and often two to three months for high-impact sports, confirmed at follow-up.

Aftercare is not just about bone. Keeping the mouth clean matters enormously when incisions and fracture lines sit inside it — gentle brushing and prescribed rinses are part of the job. Replanted teeth are splinted for a period and then monitored, sometimes for years, because they can need root canal treatment down the road. And if a tooth ultimately cannot be saved, we plan its replacement — that is where our implant and grafting services pick up where trauma care leaves off.