The face is a very important part of a person’s overall appearance. In some cases, patients are looking to fix a facial feature that has bothered them their whole lives, while others want to correct the effects of the aging process. Dr. Tahernia offers a variety of surgical options to enhance the natural beauty of your face.
A facial laceration is another term for a cut or tear in the skin of the face. In more severe laceration cases, underlying structures such as the muscles, blood vessels or nerves may be involved. As Dr. Tahernia evaluates your specific case he will determine the severity of the laceration and if there is any potential that a nerve in the face was injured.
Symptoms Of A Facial Laceration:
Most symptoms that a laceration has occurred are readily apparent such as swelling, bruising, bleeding and separation of the skin. If it is the case that the area around the laceration is becoming more swollen or increasingly painful, it may be the case that a skin infection has set in.
Treatments Of Facial Laceration:
In a majority of cases, a facial laceration can be repaired with sutures, skin adhesive or staples. The wound will first be washed out and cleansed before the actual repair occurs. In some cases a tetanus shot may be required to avoid any further serious infections. Other methods of laceration repair include:
Wound Debridement – This treatment requires the removal of dead or dirty tissue or to remove a foreign body from the wound
Surgery for Facial Lacerations – In the most severe cases of skin lacerations, surgery will be required to remove foreign bodies from the wound and to repair the damaged tissue.
In addition to the treatment that is found best for your facial laceration, antibiotics will be prescribed to fight any potential infections and pain medication will be ordered to help in managing your pain from the wound.
Recovery From Facial Lacerations:
The skin on the face recovers relatively quickly. If sutures or stables are used for the repair, they can typically be removed in just 4-5 days. However, the recovery process is individualized from patient to patient and Dr. Tahernia will discuss with you what you can expect in your recovery. Tylenol can be used to help control any bothersome pain during your recovery and if there is some slight tenderness, an ice pack can be applied. For any serious symptoms during your recovery you should seek immediate medical attention.
Mandible fractures, also referred to as jaw fractures, often occur because of the lack of support in the structure and the prominence it has on the face. Of course, like with any fracture, it is important to consider the level of emergency so that the best path of treatment can be taken. It is important especially with a jaw fracture that the airway is secure and not obscured for some reason.
Types Of Mandibular Fractures:
Closed or simple – This type of fracture does not break the skin, mucosa or the periodontal membrane.
Open or compound – An external wound occurs in this type of fracture such as that involving the skin, mucosa or periodontal membrane.
Greenstick – Situation where only one cortex is broken and the other is bent.
Atrophic – A fracture that occurs because of severe atrophy of the bone.
Multiple – Two or more lines of the fracture are present, but they do not communicate with one another.
Pathologic – A fracture that occurs from a mild injury that is linked with a preexisting bone disease.
Comminuted – The bone of the jaw is splintered or crushed in this type of fracture.
Complicated – This type of fracture occurs when there is considerable injury to the adjacent soft tissues or parts.
Treatments For Mandible Fractures
Medical treatment will first begin with the use of preoperative antibiotics to help fight any potential infections. The surgical approach to correcting a mandible fracture will be determined by Dr. Tahernia depending on the patient and the type of fracture.
Intraoral Approach – This method is often preferred over the extraoral approach because it has a lower risk for facial nerve damage and there is no external scar. This technique also is quicker to perform and can be done under a local anesthesia.
Submandibular Approach – In this approach, a small incision is made discretely in a crease of the skin that is about 2cm below the angle of the mandible. Dr. Tahernia will work his way through to the platysma muscle and then move further to reach the deep cervical fascia. Using a nerve stimulator, Dr. Tahernia can move to carry out the dissection of the pterygomasseteric sling.
Retromandibular Approach – Dr. Tahernia will place an incision about half of a centimeter below the earlobe that spans about 3.5 inches. The muscle is stripped from the surface of the mandible to give him access to the ramus and subcondylar region of the jaw.
Preauricular Approach – This approach is best used when it is necessary to get to the temporomandibular joint. An incision that spans about 2.5-3.5 cm is made in the preauricular folds. Once Dr. Tahernia has worked down to below the arch of the periosteal elevator, he can release the intervening tissue along the incision and retract the flap to expose the joint capsule. Depending on the type off fracture will determine if the capsule is opened.
The orbital, also referred to as the eye socket, makes up the bones that surround the eye. This structure is designed to protect the eye itself from injury. When a traumatic force such as that caused by a fist or car accident, an orbital facture may occur. An orbital fracture is also known as a blowout fracture.
How Is An Orbital Fracture Diagnosed?
Dr. Tahernia will first overview the symptoms that you are experiencing and then perform a selection of tests. Most commonly, a CT scan will be taken as this will show the eye socket bones in great detail and help to better define the severity of the fracture. Other tests may include measurements being taken from the eye to the cheek compared with the normal side, a dilated test to look into the back of the eye or the eye may just be looked at closely through the use of a specialized microscope.
Symptoms Of An Orbital Fracture:
Treatment Of Orbital Fractures:
In some cases, repair is not required to correct an orbital fracture. Dr. Tahernia will determine this based on whether the eye appears sunken in, whether a muscle is stuck in the broken bones, how large the fracture is and how severe the double vision is. If repair is necessary, the n surgery will be performed. In the case of a trap door fracture, the injury will need to be repaired right away. For other types of fractures, they can typically be treated within a few weeks.
If surgery is delayed, you will be prescribed a variety of antibiotics to avoid infection and some pain medication to help alleviate discomfort from the injury. Sleeping with your head elevated when sleeping and avoiding physical activity is recommended before surgery.
A small cut will be made in the eyelid skin or the tissue behind the eye to get to the broken bone. It may be the case that parts of the bone actually need to be removed. Dr. Tahernia will then place the tissue and muscles back to their original place and the hole in the bone is covered with a material to help with the repair of the fracture.
The zygoma, also referred to as the cheek bone is a very prominent aspect of the face. In situations where trauma occurs to the cheekbone whether it is because of a blunt object or car accident, a fracture may occur. Seeking treatment to repair the zygoma is crucial to restore the natural and proper contours of your face, but is also important in providing adequate support for the eye.
Zygoma Fracture Symptoms
When a patient suffers from a fracture of the cheekbone, several symptoms will occur aside from the typical swelling and bruising that is consistent with any kind of bone fracture. Other possible symptoms may include:
Flattened Facial Contour – When a fracture occurs, it can easily be noticed that the side of the face where the fracture has occurred is flatter than the normal side. It is important that the bone is brought to proper alignment so that the natural contours can be restored.
Cheek Numbness – One of the major nerves that provides sensation to the area is located at the center of the cheek bone. Fractures that occur near this nerve can result in pressure being applied to it. This can lead to their being partial or complete numbness in the face and will return to normal in about a few days after the fracture is repaired.
Unable to Open the Mouth Wide – Fractures in the cheek can lead to spasms in the muscles that help the mouth close leading to an inability to open the mouth wide. This will restore with time as the cheek heals.
Double Vision – The cheekbone is one of the bones that make up the orbit. Fractures that change the support that the cheek typical offers to the eyes can disrupt the muscles that make the eye move. Although double vision is the effect of the fracture, it is important that treatment is sought out quickly to avoid possibility of injury to the eyes.
Treatment Of Zygoma Fractures:
As Dr. Tahernia examines the injury, he will use not only a physical examination, but also a CT scan so that he can see into the depths of the severity. A CT scan allows for him to see a detailed image of the fracture and around the eyes so that the best method of corrective surgery can be set in place. You may also need to consult with an ophthalmologist to ensure that there are no injuries to the eye itself. If injury is present in the eye, then plans for surgery may need to be delayed or altered.
After all of the injuries have been addressed, Dr. Tahernia will bring the cheek bone back into alignment and secure it in its proper place. This can be done either with the use of a wire or metal plates with screws.