16025 Facial Fractures

Overview

A facial fracture is a break in one or more of the bones of your face, such as your nose, cheekbones, eye sockets, jaw, or forehead. These bones are strong, but they can break if they receive a hard hit or force.

Yes, facial fractures are fairly common, especially among younger adults. They are one of the most frequent types of injuries seen in emergency departments.

Anyone can get a facial fracture, but they happen most often in active people, especially men between the ages of 20 and 40. Older adults and children can also get them, often from falls.

Symptoms

Common symptoms

• Swelling and bruising around the face, eyes, or jaw
• Pain or tenderness when touching the area
• A visible change in the shape or symmetry of your face
• Difficulty opening your mouth, chewing, or talking
• Numbness or a tingly feeling in your cheek, lip, or chin
• Black eyes or bruising around both eyes
• A nosebleed or bloody discharge from the nose
• Loosened teeth or difficulty biting
• A crackling or grinding feeling when you move your face

Symptoms in children

• Children's facial bones are smaller and still growing, so signs may be less obvious than in adults.
• Look for stubborn crying, reluctance to eat or chew, unusual swelling, or a 'flat' look on one side of the face.
• Any significant blow to a child's face should be checked by a healthcare provider, even if symptoms seem mild.

Symptoms in older adults

• Older adults may have more bruising and swelling from the same injury because their skin is thinner and more fragile.
• Falls at home are a common cause, so older adults may also have other injuries like hip fractures, which need urgent attention too.
• Healing can take longer, and there may be a higher risk of complications like infection or poor bone alignment.

Causes

Main causes

• Falls, especially from standing height in older adults or from play in children
• Motor vehicle collisions, which can cause high-impact facial trauma
• Sports injuries, particularly in contact sports like football, boxing, or hockey
• Physical assaults or altercations
• Workplace accidents involving heavy equipment or machinery

Risk factors

• Playing contact sports without proper protective equipment
• Not wearing a seatbelt while in a car
• Riding a bicycle or motorcycle without a helmet
• Working in jobs with high risk of facial injury, such as construction or factory work
• Having a condition that weakens bones, such as osteoporosis
• Living with certain seizure disorders or balance problems that make falls more likely

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency warning signs listed above, such as trouble breathing, heavy bleeding, or loss of consciousness, call your local emergency number right away.
• Go to an urgent care or emergency department if you are unable to close your jaw, have severe facial pain, or have vision problems.

Book a routine appointment if:

• Make a same-day appointment or visit urgent care if you have persistent pain, swelling, or difficulty chewing after any facial injury.
• See a healthcare provider within a day or two if you notice a change in the shape of your face, numbness, or loose teeth, even if you can manage the pain at home.

Diagnosis

A doctor will start by asking how the injury happened and about your symptoms. They will look at your face, gently press on the areas that hurt, and check your eyes, nose, mouth, and jaw movement. Depending on the findings, they may order imaging tests to look at the bones more closely.

Tests that may be done

• X-rays — quick images that can show some fractures, especially of the nose, jaw, or cheekbones.
• CT scan — a special type of X-ray that gives detailed 3D images of the facial bones. This is the most common test for serious or multiple facial fractures.
• Maybe no tests — for very minor fractures, the doctor may rely on the physical exam alone and schedule a follow-up check.

What to expect at your appointment

The examination itself is usually not painful, but your face may be sore. The doctor will be gentle. If they need to take images, you will likely lie or sit still while the machine takes pictures. After the exam, they will explain what they found and discuss next steps. You may be referred to a specialist, such as an ear, nose, and throat doctor or a maxillofacial surgeon, for further care.

Treatment

Treatment for a facial fracture depends on which bone is broken, how far the pieces have moved out of place, and whether other structures like your eyes, nose, or teeth are affected. Many minor fractures heal well with simple care, such as rest, ice, and a soft diet. More serious fractures may need a procedure to realign the bones.

Self-care at home

• Apply a cold pack (wrapped in a thin cloth) to the area for 15–20 minutes at a time, several times a day, during the first 48 hours.
• Keep your head elevated, especially when sleeping, to reduce swelling.
• Eat soft foods that don't require much chewing, like soups, smoothies, mashed potatoes, and scrambled eggs.
• Avoid blowing your nose or putting pressure on the injured area until your doctor says it is safe.
• Take simple pain relief such as paracetamol or ibuprofen (if appropriate for you) – but always check with your pharmacist or doctor first.

Medical treatments

A doctor may prescribe pain medicine or, if there is an open wound, antibiotics to prevent infection. For certain fractures, especially those that are displaced or unstable, a specialist may perform surgery to put the pieces back in place and hold them together with small plates and screws. This brief description is for general information — your healthcare team will recommend a plan that is right for your specific injury.

When is surgery considered?

Surgery is usually needed when the bones are shifted out of alignment, a broken bone presses on your eye or airway, you have difficulty breathing or seeing, or the fracture is in a place that cannot heal properly on its own. For jaw fractures, surgery is common to ensure teeth meet correctly. Your surgeon will explain exactly what is needed.

Living with this condition

Recovery takes time — usually several weeks. Keep your head elevated when resting, avoid contact sports and heavy lifting until cleared by your doctor, and attend all follow-up appointments. If you have had surgery, you may have some numbness or swelling that fades over weeks or even months.

Lifestyle tips

• Avoid straining your face — for example, do not lift heavy weights or blow your nose too hard, unless advised by your healthcare provider.
• If you smoke, try to stop or cut down, as smoking slows down bone healing.
• Protect your face from additional injury during recovery — wear a helmet or face guard for sports if your doctor allows.
• Be patient with your appearance — swelling can take several weeks to completely go down.

Diet and exercise

Eat a balanced diet rich in calcium and protein, as these help bones heal — think dairy products, leafy greens, fish, eggs, and beans. Soft foods are best if chewing is painful. You should avoid strenuous exercise or anything that might jostle your face until your doctor gives you the green light. Gentle walking is usually fine.

Mental health and emotional wellbeing

Having a facial fracture can be a major event. Changes to your appearance, difficulty eating, or needing surgery can make you feel anxious, self-conscious, or low in mood. It is normal to have these feelings. If you feel overwhelmed or worried about how you look or how you are coping, talk to your healthcare provider. They can offer support and, if needed, connect you to a counselor.

Prevention

You cannot always prevent an accident, but you can reduce your risk of facial fractures by using seatbelts, wearing a helmet while cycling or riding a motorcycle, and using the correct protective gear for contact sports. Making your home safer (for example, securing rugs and adding handrails) can help prevent falls, especially for older adults.

Complications

If left untreated

• The bone may heal in the wrong position, causing a visible deformity or uneven face.
• You may develop long-term problems with chewing, biting, or speaking.
• An untreated eye socket fracture could lead to double vision or vision loss.
• There is a risk of infection if the fracture is open (the skin is broken) and bacteria enter the wound.
• Nerve damage could cause permanent numbness or weakness in parts of your face.

Long-term outlook

With proper medical care, most facial fractures heal very well. Even if surgery is needed, modern techniques are very effective and can restore both function and appearance. It may take time, but most people return to their usual activities with no lasting concerns. You do not have to go through this alone — your healthcare team will support you throughout your recovery.

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