Facial Trauma Surgery – Putting back the Pieces

Facial Trauma Surgery

Facial trauma is unfortunately common. Facial bones are fragile and fractures can result from sporting injuries, car accidents and, of course, interpersonal violence. Facial trauma can result in problems with chewing and breathing, damage to vital structures (such as the eye), and permanent disfigurement if the injuries are not treated appropriately.

Damian Marucci
Dr Damian Marucci
Cosmetic Plastic Reconstructive Surgeon
Plastic surgery is a diverse specialty and you may not know that plastic surgeons are often called upon to treat facial trauma. This might involve suturing facial lacerations, realigning broken bones (like the jaw or cheek bones), even repairing damaged nerves or blood vessels. Plastic surgeons aim to fix the functional issues (like getting the “bite” right after someone has broken their jaw) as well as recreating the aesthetic harmony of the face (by putting everything back where it should be with the least amount of scarring). Dr Damian Marucci, Plastic Surgeon based in Kogarah, Sydney NSW has a special interest in facial trauma. We spoke with him about this more serious side to plastic surgery.

Facial Trauma Surgery

As a plastic surgeon at St George Hospital in Sydney, Dr Marucci regularly treats complex facial injuries. St George Hospital is the designated trauma centre for the whole of South East Sydney and the Sutherland Shire. Whilst weekend sporting accidents, work accidents and social activities combined with alcohol are common sources of the injuries, it’s the interpersonal violence cases that are rising at an alarming rate. Dr Marucci says, “The nasal bones are the most commonly fractured facial bones. Usually, they are pushed over to one side, causing a nasal deviation. Sometimes the septum (the cartilage that runs down the middle of the nose, dividing it into two halves) can also be affected. The deformity of a broken nose can become permanent if the bones aren’t straightened within 10 days of the trauma. If the nasal bones remain in a bad position, the only way to re-straighten the nose is through a rhinoplasty. This is a more significant surgical procedure, so it’s important to straighten the nasal bones before they set.”

Dr Marucci continues, “The face contains a number of specialised structures, like the eye and nose, in addition to skin, muscles, nerves, bones and blood vessels. The severity of an injury is often determined by which structures are involved with the trauma. The bones of the face are delicate and so facial fractures are not uncommon.”

There are, however, several potential life-threatening or life altering complications of facial trauma including:

  • Blockage of airways due to bleeding, swelling or damage to structures, resulting in breathing difficulties.
  • An abnormal bite, or “malocclusion”, if either upper or lower jaws are broken and not realigned properly
  • Disability due to the trauma such as
    • Partial or full blindness
    • Problems with jaw function
    • Loss of facial movement or sensation due to nerve damage
    • Muscle damage affecting movement, speech and swallowing
    • Inability to properly close and protect the eyes due to eyelid damage or secondary scarring
    • Chronic pain
  • Disfigurement due to
    • Scarring
    • Bones not put back into their correct position
    • Soft tissue structures not being correctly repaired or repositioned
  • Social and emotional repercussions such as self-esteem, social anxiety, embarrassment and a myriad of other psychological effects.

Dr Marucci says “My goal is to treat facial injuries with a result that is functional AND cosmetic. I regularly treat complex facial injuries in my capacity as a surgeon working in a busy trauma centre like St. George Hospital. Facial trauma surgery can also be performed in one of the many private hospitals at which I work. All consults are confidential and a plan will be tailored specifically for you.”

If you’d like to arrange a consult with Dr Damian Marucci phone (02) 9588 6374.

To read more about Dr Damian Marucci check out these blogs:
Trish talks to Dr Damian Marucci, one of Sydney’s leading plastic surgeons
Q&A with Dr Damian Marucci – Your most common plastic surgery questions answered
Dr Damian Marucci – A Surgeon with a Big Heart