Facial trauma is an injury of the face. It may include the facial bones such as the upper jaw bone (maxilla).
Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries
Facial injuries can affect the upper jaw, lower jaw, cheek, nose, eye socket, or forehead. They may be caused by blunt force or be the result of a wound.
Common causes of injury to the face include:
- Car and motorcycle crashes
- Sports injuries
Symptoms may include:
- Changes in feeling over the face
- Deformed or uneven face or facial bones
- Difficulty breathing through the nose due to swelling and bleeding
- Double vision
- Missing teeth
- Swelling or bruising around the eyes that may cause vision problems
Exams and Tests
The health care provider will perform a physical exam, which may show:
- Bleeding from the nose, eyes, or mouth
- Nasal blockage
- Breaks in the skin (lacerations)
- Bruising around the eyes or widening of the distance between the eyes, which may mean injury to the bones between the eye sockets
- Changes in vision or the movement of the eyes
- Improperly aligned upper and lower teeth
The following may suggest bone fractures:
- Abnormal feelings on the cheek
- Irregularities of the face that can be felt by touching
- Movement of the upper jaw when the head is still
A CT scan of the head and bones of the face may be done.
Surgery is done if the injury prevents normal functioning or causes a major deformity.
The goal of treatment is to:
- Control bleeding
- Create a clear airway
- Treat the fracture and fix broken bone segments
- Prevent scars, if possible
- Prevent long-term double vision or sunken eyes or cheek bones
- Rule out other injuries
Treatment should be done as soon as possible if the person is stable and does not have a neck fracture.
Most people do very well with proper treatment. More surgery may be needed in 6 to 12 months to correct changes in appearance.
Complications may include:
- Uneven face
- Brain and nervous system problems
- Numbness or weakness
- Loss of vision or double vision
When to Contact a Medical Professional
Go to the emergency room or call the local emergency number (such as 911) if you have a severe injury to your face.
Wear seat belts while driving.
Use protective head gear when doing work or activities that could injure the face.
Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 23.
Mayersak RJ. Facial trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 35.
Neligan PC, Buck DW, Facial injuries. In: Neligan PC, Buck DW, eds. Core Procedures in Plastic Surgery. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 9.