Automobile accidents can be the cause of severe facial trauma and even disfiguration. Often times in surgery following an accident, the surgeon is focused on saving the life of the patient. Treating problems with airway, breathing, circulation and any other life-threatening emergencies takes the priority before treating facial injuries. In particular, a doctor who is examining a patient with severe facial trauma will be more concerned about damage to the brain, the spinal cord in the neck, the eyes, and other vital organs. The second priority is to treat and control severe bleeding.
Once the patient is stabilized, any facial reconstruction may need to be postponed 24 – 72 hours in order to treat injuries to other organs. The best way to prevent post-traumatic facial deformities is to obtain the appropriate treatment at the time of the injury. Delayed treatments don’t have as successful of a result as immediate care. Unfortunately, there are some patients who are injured in such a way that the surgeons and medical teams do not consider facial reconstruction or other facial treatments advisable until after this window of time has passed. Due to their life-threatening injuries, some patients cannot receive treatment of their facial injuries for quite some time following the accident.
If surgery is done at the initial time of the injury, or months or even years later, the process is basically the same. The first step is to evaluate the damage and disfiguration using x-rays and CT scans. The surgeon considers what repairs are needed, and the best way to accomplish the tasks. This type of surgery if more of an art form, rather than science. The surgeon may remove tissues, re-connect blood vessels and nerves (sometimes using microscopic tools), or graft bone from the pelvis, ribs or skull to the face. Titanium mini-plates, metal screws and wire are sometimes used to hold the jaw or a bone graft in place.
If large areas of skin are missing , burned, or damaged, the surgeon may use a flap, which is a section of living tissue carrying its own blood supply, from the back, thigh, buttocks, or another area of the patient’s body and transplant it to the face. Some facial injuries may require the assistance of a neurosurgeon, oral surgeon, or ophthalmologist.
There are a few possible complications from this type of surgery. As with any surgery, the patient may not react well to the anesthesia or medicine. Facial reconstruction surgery patients often experience swelling of the face and throat. This swelling can sometimes close the windpipe or esophagus and necessitate the temporary placement of breathing or feeding tubes.
If a patient doesn’t face any complications, the prognosis is usually good. He or she may be able to leave the hospital within a week and shouldn’t feel pain from the surgery for more than six weeks. Perhaps the major long-term complication from the surgery manifests in mental challenges as the patient adjusts to a new appearance. The change can often lead to stress, depression and anxiety disorders.
