Facial trauma — injuries to the bones and soft tissues of the face — requires prompt, expert assessment. The face is structurally complex: the bones of the upper and lower jaw, cheekbones, orbital floor, nasal bones, and their associated soft tissues are closely interrelated in both function and aesthetics. Injuries that affect any of these structures can impair breathing, vision, chewing, speaking, and the symmetry of the face if not accurately diagnosed and treated. At Al Safwa Medical Center in Bani Yas, Abu Dhabi, the facial trauma surgery team within the maxillofacial department manages the assessment and surgical treatment of facial injuries — from fractured jaw bones to complex midface fractures — with the goal of restoring both function and appearance.
This guide explains what facial trauma surgery covers, which injuries require surgical treatment, how assessment and treatment are approached, and what recovery involves. If your concern is specifically jaw joint pain rather than injury, the TMJ disorder treatment guide is more relevant. For jaw position surgery unrelated to trauma, the jaw surgery guide covers orthognathic procedures.
What causes facial trauma and who is affected?
Facial injuries can result from a wide range of mechanisms. In Abu Dhabi and the UAE, the most common causes presenting to maxillofacial units include:
- Road traffic accidents — the most common cause of significant facial fractures, particularly midface and mandibular fractures
- Sports injuries — contact sports, cycling, martial arts, and falls during physical activity are a significant source of dental and facial trauma
- Falls — particularly in older adults and young children
- Workplace injuries — construction and industrial environments in the UAE present specific risk profiles
- Assaults
- Dental trauma during procedures — rare, but significant tooth avulsion or fracture can occur
Facial trauma affects patients of all ages — from young children who sustain dental injuries during active play to adults with complex multi-site fractures from high-energy mechanisms. The management approach is tailored to the age of the patient, the specific structures injured, and the functional and aesthetic consequences of the injury.
Types of facial injuries treated at Al Safwa
Mandibular (lower jaw) fractures
Fractures of the mandible are among the most common facial fractures treated surgically. The mandible is a U-shaped bone and frequently fractures in two or more places simultaneously. Common fracture sites include the body, the angle (where wisdom teeth are located), the condyle (the joint area), and the symphysis (the chin area). Symptoms include pain, limited mouth opening, bite change, swelling, bruising, and sometimes numbness in the lower lip and chin if the inferior alveolar nerve is involved.
Treatment depends on the fracture pattern and displacement. Minimally displaced fractures with an intact bite may be managed conservatively with a soft diet. Displaced or unstable fractures require open reduction and internal fixation — the fracture is surgically repositioned and stabilised with titanium plates and screws through incisions inside the mouth or through minimal external approaches. The jaw is no longer wired shut as standard treatment in modern maxillofacial surgery — internal fixation allows early jaw mobility and return to function.
Zygomatic (cheekbone) fractures
The zygoma — the cheekbone — is prominent and frequently fractured in direct blows to the face. A zygomatic fracture produces characteristic flattening of the cheekbone, swelling and bruising around the eye, possible restriction of mouth opening (trismus) if the zygomatic arch impinges on the coronoid process of the mandible, and sometimes double vision or numbness in the cheek and upper lip if adjacent nerves are affected.
Treatment depends on displacement and functional impact. Undisplaced fractures that do not affect mouth opening or vision are managed conservatively. Displaced fractures require elevation or open reduction and fixation to restore the facial contour and relieve any mechanical obstruction to jaw movement.
Midface fractures (Le Fort fractures)
High-energy trauma — particularly from road traffic accidents — can fracture the midface at characteristic levels described by the Le Fort classification. These fractures involve the upper jaw, cheekbones, and in severe cases the nasal bones and orbital walls. Symptoms can include mobility of the entire midface on clinical examination, bite changes, swelling, and in complex cases, visual disturbance or nasal obstruction. Management involves surgical reduction and fixation of all the fracture components to restore the correct three-dimensional facial skeleton.
Orbital floor fractures
A direct blow to the eye can fracture the thin bone forming the floor of the orbit — the eye socket — causing orbital contents (including the inferior rectus muscle) to herniate into the maxillary sinus below. Symptoms include double vision (particularly on upward gaze), enophthalmos (sunken eye appearance), and numbness in the cheek from infraorbital nerve involvement. Surgical repair — usually via an approach through the lower eyelid or through the mouth — reconstructs the orbital floor to restore normal eye position and movement.
Dentoalveolar trauma (tooth and supporting bone injuries)
Injuries to the teeth and the bone that supports them — including tooth fractures, luxations (loosened or displaced teeth), avulsions (teeth knocked completely out), and alveolar bone fractures — are managed by the maxillofacial and dental teams together. The treatment of each type depends on the tooth involved, the severity of the displacement, the time elapsed since the injury, and whether the tooth is primary or permanent.
An avulsed permanent tooth — knocked completely out of the socket — is a dental emergency. The chance of successful reimplantation is highest when the tooth is replanted within 30 minutes of avulsion and stored correctly (in milk, saline, or the patient’s own saliva) during transport to the clinic. Patients who experience this should contact Al Safwa Medical Center immediately.
How facial trauma is assessed
A systematic clinical assessment is the foundation of facial trauma management. The assessment covers:
Airway and immediate concerns. Significant facial trauma can compromise the airway. This is assessed and managed as an absolute priority before any other evaluation.
Systematic clinical examination. Palpation of all facial bones for step deformity, crepitus, or mobility. Assessment of mouth opening, bite relationship, eye position and movement, nasal symmetry, and soft tissue injuries. Neurological assessment of facial sensation and motor function.
Imaging. Facial radiographs provide initial information. CT scanning with 3D reconstruction is the gold standard for facial trauma assessment — it provides precise information about fracture pattern, displacement, and the involvement of adjacent structures that guides surgical planning. For dental injuries, periapical radiographs assess the teeth and supporting bone specifically.
Timing of facial trauma surgery
Not all facial fractures require immediate surgery. The decision on timing involves the nature of the injury, the degree of swelling present, and any associated injuries. The general principles are:
Immediate surgery is required for airway compromise, significant haemorrhage, or injuries causing immediate visual threat (such as severe orbital haematoma).
Urgent surgery within 24–48 hours for fractures with active functional problems — severely displaced fractures causing inability to close the mouth, or globe injuries requiring orbital reconstruction.
Semi-elective surgery within 5–10 days for most displaced facial fractures — after initial swelling has begun to resolve but before fracture healing begins to fix the bones in an incorrect position.
Conservative management for undisplaced, clinically stable fractures that do not impair function.
Recovery after facial trauma surgery
Recovery varies significantly depending on the nature and extent of the injuries. After surgical fixation of facial fractures:
Swelling and bruising peak in the first 48–72 hours and resolve over two to three weeks. Significant facial swelling is expected after surgery and is not a sign of a problem. Ice packs and keeping the head elevated reduce the extent of post-operative swelling.
Diet is restricted to soft or liquid foods while fractures consolidate — typically four to six weeks for mandibular fractures, somewhat shorter for midface fractures where internal fixation is rigid.
Activity is restricted to avoid re-injury during bone healing. Contact sports and activities with a risk of impact to the face are avoided for at least six weeks post-operatively.
Numbness in the distribution of injured nerves — particularly the inferior alveolar nerve in mandibular fractures and the infraorbital nerve in midface fractures — typically recovers over weeks to months as the nerve regenerates, though some cases of prolonged or permanent altered sensation do occur depending on the severity of nerve involvement.
Facial injury or dental trauma in Abu Dhabi?
At Al Safwa Medical Center in Bani Yas, Abu Dhabi, the facial trauma surgery team provides assessment and management of facial fractures and dental injuries. For dental emergencies including avulsed teeth, fractured teeth, and significant dentoalveolar injuries, prompt assessment is essential to maximise the chances of successful treatment.
- Facial trauma surgery Abu Dhabi
- Jaw surgery Abu Dhabi
- TMJ disorder treatment Abu Dhabi
- Maxillofacial surgery Abu Dhabi
- General dentistry Abu Dhabi
- Contact us urgently for facial injury
The Al Safwa maxillofacial team is experienced in assessing and managing the full spectrum of facial injuries — from isolated tooth trauma to complex multi-site facial fractures.
Frequently asked questions
How do I know if my jaw is broken?
Signs of a mandibular fracture include pain in the jaw especially on movement, difficulty or inability to open the mouth fully, a change in how your teeth fit together when you close your mouth, swelling and bruising around the jaw, and sometimes numbness in the lower lip or chin. Not all broken jaws have all these symptoms — some undisplaced fractures are identified only on imaging. Any significant blow to the jaw that causes persistent pain or bite change warrants clinical assessment.
What should I do if a tooth is knocked out?
Pick the tooth up by the crown (not the root), rinse it gently with milk or saline if dirty without scrubbing, and either replant it immediately into the socket yourself or store it in milk, saline, or inside your cheek. Seek dental treatment immediately — within 30 minutes if possible. The chance of successful long-term reimplantation decreases significantly with time and is very low after 60 minutes. Contact Al Safwa Medical Center immediately in this situation.
Does facial fracture surgery leave visible scars?
Modern maxillofacial surgery uses intraoral incisions (inside the mouth) wherever possible, leaving no visible external scars. Certain fractures — particularly around the eye or cheekbone — may require small external approaches through natural skin creases or the lower eyelid. These incisions are designed and closed to minimise long-term scarring. Soft tissue lacerations from the original trauma are repaired with meticulous technique to reduce scar visibility.
Are the titanium plates used in facial fracture repair permanent?
Titanium plates and screws used for internal fixation are typically left in place permanently. They are inert, do not cause problems in the vast majority of patients, and do not need to be removed. In a small number of cases — where a plate becomes palpable, causes discomfort, or is associated with infection — removal can be considered after bone healing is confirmed, typically no earlier than 6 to 12 months post-surgery.
How long after facial fracture surgery can I return to sports?
Return to non-contact physical activity typically begins at four to six weeks after surgery. Return to contact sports or activities with a risk of facial impact is generally deferred until at least three months post-surgery, after radiographic confirmation that bone healing is sufficient to withstand normal sporting forces. Your surgeon will advise specifically based on your injury and the sport involved. Protective face guards are recommended for athletes returning to contact sports following facial fractures.
