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Facial Fracture Fixation
Your Procedure
You have had a “repair of facial fractures” - a procedure whereby the bones of the facial skeleton are put into their correct position and sometimes held in place with wires, plates, or screws. This is done through tiny incisions hidden on your face or sometimes inside the mouth.
What to Expect
Swelling and bleeding are very common after this procedure, and bruising can last for several weeks. Sometimes your eyes can swell shut and sometimes your bite can feel “off”, but these both improve with time. It is also common to have blood in the nose and sinuses causing congestion, and to have areas of the face that are numb or tingly. If this is daycare surgery you will need a responsible adult to take you home and stay with you that night.
Surgical Site Care
General care: Avoid putting any pressure on the surgical area, especially the nose, cheekbones, or forehead, as it is quite easy to shift the small bones of the face before they can heal. You should avoid blowing your nose and try sneezing with your mouth open if your surgery involves your sinuses.
Incision care: Apply a very small amount of antibiotic ointment available over the counter at the pharmacy to incisions. You may shower after 48 hours.
Oral care: If you have incisions in your mouth, rinse regularly with salt water and use the prescribed chlorhexidine mouthwash as directed. You can gently eat soft foods that can easily be crushed between your finger and thumb (as a test), but you should not chew or bite anything hard for 4 weeks.
MMF: If your upper and lower jaw have been wired shut or held together with elastics, you need to be on a blenderized or pureed diet until advised by your surgeon, typically 4 weeks.
Activity and Care at Home
Keep your head elevated above your heart with extra pillows while sleeping or lying down and use ice packs for the first few days to help bring down the swelling. You want to avoid working out or strenuous activity, or any “head-down” activity like heavy lifting or straining as this can increase bleeding, for at least 4 weeks. You should engage in contact sports for 8 weeks.
Medications and Pain Management
Some discomfort and pain following surgery is to be expected. You should take Ibuprofen (Advil) and Acetaminophen (Tylenol) every 6 hours as directed on the container labels. If more pain is expected, you will be given a prescription that you can take in addition to this. Do not exceed the recommended doses. Keep surgical areas elevated and avoid any strenuous activities. For further information on pain management, please refer to the post-operative pain instruction sheet.
What to watch for / when to call / who to call
Uncontrollable pain, loss of vision, uncontrolled bleeding, purulent or malodorous discharge, or significant systemic problems such as fever or being very unwell are not normal postoperatively. Should you experience these, please contact the office.
Even if you plan to go to the emergency please call the surgeon as this may save you considerable time.
Follow-up
Your post-operative visits should be pre-scheduled at the time of surgical booking unless your surgery was urgent. If you are unsure of your follow up dates, please contact our office. Usually, follow up is arranged according to the following.
Removable sutures on the face - 7 days
Removable sutures on the scalp and neck - 7 days
Dissolving sutures - 7-14 days
Removal of MMF - varies between 2-6 weeks