Does every facial fracture need surgery?
No. Some stable fractures can heal with observation and protective care.
Displacement, bite changes, eye involvement, and facial stability help determine whether repair is needed.
Face & Neck · Facial trauma care
Facial Fracture Repair
Facial fracture repair treats broken facial bones to restore alignment, support healing, and address changes in bite, vision, or facial shape.
How soon is repair needed?
Timing depends on the injury and any urgent threats to breathing or vision.
Some injuries need immediate treatment; others are repaired after swelling decreases and the full injury is assessed.
Who treats facial fractures?
Care may involve several surgical specialists.
A plastic surgeon, oral and maxillofacial surgeon, ear, nose, and throat surgeon, or eye specialist may participate, depending on the bones and nearby structures affected.
01 · Overview
Understanding facial fracture repair
Facial fractures are breaks in one or more facial bones, often after a fall, collision, sports injury, or assault. Swelling can hide changes in bone position, so examination and imaging help define the injury. [1]
Repair may involve moving bones back into alignment and holding them with plates, screws, splints, or other supports. Not every fracture requires an operation. The plan depends on stability, bone position, and effects on breathing, vision, chewing, and facial shape. [1]
Facial fracture repair is reconstructive trauma care, not a cosmetic facelift or elective reshaping procedure. A later procedure may address remaining contour or breathing concerns, but the first priority is safe healing and preservation of function.
- Main purpose
- Restore facial bone alignment and function
- Areas treated
- Jaw, cheekbone, eye socket, nose, or midface
- Anesthesia
- Depends on the repair; often general anesthesia
- Care setting
- Outpatient surgery or hospital admission
Why might several specialists examine me?
Facial bones surround the eyes, airway, teeth, nerves, and sinuses. Your team may check these structures and assess for head or neck injuries before planning repair.
What does imaging show?
CT scans often help identify fracture patterns and displacement. Dental imaging or other tests may be useful for particular injuries. Imaging is interpreted alongside your examination.
02 · Concerns & Goals
What an injury may change
A facial injury can affect how you look, feel, and function. Some changes need urgent evaluation before decisions about repair.
A changed bite
Teeth that no longer meet normally, trouble chewing, or limited jaw movement can signal a jaw or midface injury.
Vision or eye position
Double vision, difficulty moving an eye, or a change in eye position needs assessment. Sudden vision loss is an emergency.
Facial shape or support
A flattened cheek, crooked nose, or new asymmetry may reflect displaced bone, although early swelling can obscure the picture.
Numbness or breathing changes
Injury can affect facial nerves and nasal airflow. Tell your team about altered sensation, blocked breathing, or symptoms that are worsening.
03 · Options
How the approaches differ
These approaches are not interchangeable. Your surgeon recommends a plan based on the fracture pattern, examination, imaging, and your overall health.
Observation and protective care
Allowing selected stable fractures to heal without surgery.
How it worksFollow-up examinations monitor alignment and function while activity and diet may be adjusted.
May suitSome nondisplaced fractures without significant functional problems.
Main tradeoffMonitoring remains important because symptoms or alignment can change.
Closed reduction
Moving displaced bones into position without directly exposing the fracture through an incision.
How it worksThe surgeon manipulates the bones and may use a splint or other support.
May suitSelected nasal and other fracture patterns that can be aligned and supported this way.
Main tradeoffIt may not provide enough stability for complex or markedly displaced fractures.
Open reduction and internal fixation
Directly aligning broken bones and securing them with hardware.
How it worksIncisions provide access to the fracture; plates and screws help maintain position during healing.
May suitMany displaced or unstable jaw, cheekbone, and midface fractures.
Main tradeoffSurgery adds risks such as infection, scarring, nerve injury, and hardware problems.
Orbital reconstruction
Repairing selected fractures of the bones surrounding the eye.
How it worksThe surgeon frees trapped tissue when present and may rebuild damaged support with an implant or graft.
May suitCertain eye socket fractures affecting eye movement, position, or support.
Main tradeoffDouble vision or position changes may persist, and surgery carries risks to the eye and surrounding structures.
Jaw fractures may also require temporary fixation between the upper and lower jaws, using elastics or wires. Ask how any proposed fixation would affect eating, oral care, and emergency planning. [1] [2].
Will plates and screws need removal?
Many can remain in place after healing. Removal may be considered if hardware becomes infected, exposed, painful, or causes another problem. Children may need different planning because their facial bones are still growing.
Can repair improve appearance as well as function?
Restoring bone position can help restore facial contours, but swelling, soft-tissue injury, and the severity of the fracture affect the result. Perfect symmetry cannot be promised.
04 · Results
What may improve and what may remain
Function
Repair aims to improve alignment and protect everyday functions.
- Bite, chewing, eye movement, and nasal breathing are assessed according to the injury.
- Dental, eye, or nerve damage may require treatment beyond bone repair.
Facial shape
The appearance becomes easier to judge as swelling settles.
- Bone alignment and soft-tissue healing both influence facial contours.
- Some asymmetry, scars, or contour changes may remain.
Longer-term healing
Recovery may continue after the bones become stable.
- Numbness and stiffness can improve slowly, but may be lasting.
- Persistent bite, vision, breathing, or hardware problems may need further treatment.
The extent of the injury and involvement of nearby structures influence recovery. Repair cannot always reverse damage caused at the time of trauma. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery differs substantially between an isolated nasal fracture and complex jaw or midface reconstruction. Your surgical team's instructions should reflect your specific injuries and repair.
Step 1 · Day of repair
Treatment day
The team monitors breathing, bleeding, pain, and any eye or bite concerns. Some patients go home with support; others need hospital monitoring.
Step 2 · First several days
Early recovery
Swelling, bruising, soreness, and limited movement are common. Follow your prescribed wound, mouth, diet, and medication plan. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Step 3 · Following weeks
Follow-up and protection
Visits check healing, alignment, bite, and eye function as needed. Splints, elastics, sutures, or other supports are managed according to your repair.
Step 4 · Over weeks to months
Gradual return
Activity increases as your team confirms healing. Swelling and altered sensation may last longer than work restrictions, and some symptoms require ongoing care.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work or schoolPlanning context: Timing depends on symptoms, job demands, and associated injuries.What affects it: Desk work may be possible before physical work; returning does not mean the bones are fully healed.
Eating and oral carePlanning context: Especially important after jaw or midface repair. [2]What affects it: You may need a liquid or soft diet and a specific cleaning plan while the bones and incisions heal.
Exercise and contact sportsPlanning context: Impact and heavy exertion can threaten the repair. [1]What affects it: Ask for separate clearance for light exercise, lifting, and activities with a risk of facial contact.
Nose blowing and pressure changesPlanning context: Relevant to some nasal, sinus, and eye socket fractures. [1]What affects it: Ask whether nose blowing, flying, or diving needs to be restricted and for how long.
Do not use another patient's recovery schedule as your own. Associated head, neck, or eye injuries may add restrictions.
Before your procedure
- Share the injury timeline, prior treatment, imaging, and any changes in vision, bite, or breathing.
- Provide your medication, supplement, allergy, and medical history, including blood thinners.
- Ask which medicines to continue or pause; do not stop prescribed medicines on your own.
- Discuss nicotine, alcohol, and other substance use so anesthesia and healing plans are appropriate.
- Confirm fasting, transportation, home support, and admission arrangements if surgery is planned.
- Ask about diet, oral care, follow-up visits, and an emergency plan if your jaws will be held together.
What if my jaws are held together?
Your team should explain feeding, hydration, oral care, and what to do if vomiting or breathing difficulty occurs. If emergency release equipment is needed, you and your caregiver need specific training before discharge.
Is numbness always permanent?
No. Swelling or nerve bruising can cause temporary numbness, but a severely injured nerve may not fully recover. Tell your surgeon where sensation has changed and whether it is improving or worsening.
06 · Safety
Risks and what your clinician assesses
Swelling, bruising, soreness, temporary numbness, and restricted chewing or movement can occur after injury and repair. Your team should explain what is expected for your fracture and which changes need prompt attention.
Bleeding and infection
Bleeding, a collection of blood, or infection may require medication, drainage, or another operation.
Healing or alignment problems
Bones may heal slowly, fail to unite, or heal in a position that leaves a changed bite or facial contour.
Nerve or dental injury
Altered sensation, weakness, tooth damage, or persistent pain may result from the original injury or its treatment.
Eye and vision problems
Eye socket injuries and repair can involve persistent double vision, altered eye position, or, rarely, loss of vision.
Scars and hardware concerns
Visible scars, palpable or exposed hardware, and ongoing asymmetry may require further treatment.
Anesthesia and general complications
Anesthesia reactions, breathing problems, and blood clots are possible. Your health and the extent of trauma affect these risks.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Fracture location, displacement, stability, and time since injury
- Vision, airway, bite, dental health, and nerve function
- Associated head, neck, and other injuries
- Medical conditions, medications, nicotine use, and ability to manage aftercare
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope of repair, including specialist involvement, facility care, and follow-up. Emergency treatment and insurance coverage may affect how charges are arranged.
Surgeon
Surgical care
Surgeon evaluation, fracture repair, and any additional specialist procedures.
Ask your surgeonAsk which surgeons bill separately and whether later corrective procedures are included.
Facility
Anesthesia and facility
Anesthesia services, operating room use, and outpatient or inpatient care.
Ask your surgeonAsk about network status, admission charges, and separate professional bills.
Supplies
Supplies and follow-up
Hardware, splints, imaging, medications, and postoperative visits.
Ask your surgeonConfirm which items are included and how additional imaging or hardware removal would be billed.
TRC
Patient Services
Any separately arranged coordination or support services.
Ask TRCAsk whether these services apply, what they include, and whether they carry a separate charge.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is this the same as cosmetic facial surgery?
No. Facial fracture repair treats traumatic bone injury. Restoring appearance can be part of reconstruction, but preserving function and supporting healing are central goals.
Will I have visible scars?
Some repairs use incisions inside the mouth or through existing wounds or natural creases. Others need external access. Your surgeon can explain the planned approach and where scars may remain.
Can an old fracture still be treated?
Sometimes. A healed fracture with lasting bite, contour, or breathing problems may need a different reconstructive approach than a recent injury. Examination and imaging help clarify the options.
Will insurance cover repair?
Trauma-related reconstruction may be covered, but benefits, authorization requirements, network rules, and patient responsibilities vary. Check with your insurer and treating providers without delaying emergency care.
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Sources
- [1]Cleveland Clinic: Facial FracturesFacial fracture types, symptoms, imaging, observation versus surgical repair, complications, activity precautions, and urgent evaluation for breathing or vision problems.
- [2]MedlinePlus: Broken or dislocated jawJaw fracture symptoms, fixation with wires or bands, dietary restrictions, and emergency precautions during jaw immobilization.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.