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Houston Cranio Facial

Facial Trauma Reconstruction

We understand that many types of facial trauma — which include fractures in the jaw, orbital or eye socket, nose, cheek bones, forehead, or even skull — can be very debilitating. These injuries require early evaluation and treatment planning by a highly skilled plastic and craniofacial surgeon. Dr. Eric Payne is extensively trained in assessing and reconstructing many different types of facial trauma at the Craniofacial and Plastic Surgery Center of Houston. With our experienced medical team and advanced craniofacial technology, Dr. Payne can provide you with the most optimal treatment plan to restore the function and appearance of your facial structures. 

How is Facial Trauma Treated? 

The types of facial fractures repaired by Dr. Payne include nasal fractures, orbital fractures, zygoma fractures, maxillary fractures, mandibular fractures, and frontal sinus fractures. These types of injuries typically require an x-ray or CAT scan of the face to properly assess the damage. If a patient’s fractures are displaced, correcting these injuries usually requires reduction and fixation using metal plates and screws. Sometimes lacerations can occur, which may possibly necessitate nerve or arterial repair.  He can evaluate your facial trauma and, if necessary, develop a nasal and facial reconstruction plan to address your injuries.

How is Facial Trauma Reconstruction Performed?

A range of surgical techniques can be utilized to reconstruct the facial structures, including free tissue transfer, use of implants and prosthetic devices, and 3D modeling, among other approaches. Dr. Payne will discuss whether your reconstruction will be performed during one procedure, or in multiple stages. Surgery is typically performed under general anesthesia, with some patients undergoing an outpatient procedure and others requiring an overnight stay. 

Microvascular Free Tissue Transfer

Microvascular tissue or “free flap” transfer involves using skin, muscle, bone, and/or cartilage from another part of the body to reconstruct damaged facial features and achieve an outcome that looks as natural as possible. This is often performed using microsurgical techniques to reconnect the “free flap” to the blood supply, veins, and arteries.  

Delayed Reconstruction

Occasionally, fractures and other facial injuries do not get repaired at the initial time of injury, requiring delayed reconstruction. This can lead to non-union or malunion of the bone fractures — meaning the bones are healing in the incorrect position or did not heal at all. When this occurs, it becomes very difficult to reduce the bone to the normal anatomical position during surgery. To aid in the surgical treatment, special 3D CAT scans can be obtained to develop virtual surgical modeling. This involves creating a 3D-printed plastic skull model, which can be manipulated prior to surgery to determine the correct anatomical position of the bones as well as confirm where to make cuts in the bones (also known as osteotomies). 

A second 3D-printed plastic skull model can showcase the desired surgical outcome even before surgery is performed. This advanced technology allows us to create special metal plates designed to hold the bones in the proper positioning and allow for optimal healing after surgery. This new, revolutionary technique reduces the amount of time spent in the operating room and the accuracy of the results dramatically improves, leading to fewer re-operations in the future.

I broke my cheekbone in a baseball accident and Dr. Payne was one of the few dr I could find that was skilled to fix it. His staff helped my wife understand what was covered by insurance and what was not. They were able to get me in quickly and repair the broken bones without any scars on the outside of my face. Beyond impressed with Dr. Payne and his team. To make it even better, I found some books in his lobby showing pictures from trips where he helped to repair facial deformities in underprivileged children. So cool to see someone use their gifts and talents to serve others. HIGHLY RECOMMEND him.


F45 Greatwood Chad

May 03, 2017


What Can I Expect From the Facial Trauma Reconstruction Recovery Period?

Each person’s recovery timeline after facial trauma reconstruction varies depending on the extent of correction needed and the surgical techniques necessary to repair damage. Dr. Payne will thoroughly discuss what you can expect during the healing period based on your unique case and the details of your treatment plan. Generally speaking, some extent of facial bruising and swelling are likely immediately after your surgery. Bandages and surgical dressings will be placed to help reduce inflammation and protect your incisions following your procedure. These reactions will subside naturally as the bones and soft tissues of the face heal, although ice packs and pain medication may be utilized as needed to accelerate the process. Most patients require a few weeks of recovery before resuming their normal routines. Exercise and strenuous activities should be avoided until Dr. Payne instructs otherwise. Complex cases of facial trauma reconstruction may require a relatively longer recovery period when compared to repairing more straightforward injuries. 

How Much Does Facial Trauma Reconstruction Cost? 

Repairing damage from facial trauma is so subjective to each patient’s unique needs, it’s generally impossible to assess the cost of treatment without an initial consultation. You can be confident that our office will provide you with a personalized cost estimate, as well as a breakdown of the anticipated expenses, after Dr. Payne is able to evaluate your injuries in person. Our team will also be able to guide you through the insurance process and help you understand the expenses applicable for full or partial coverage. For any out-of-pocket costs, flexible financing plans offered by CareCredit® may be able to help qualified patients better manage their expenses. Please don’t hesitate to contact our Houston practice if you have additional questions about your financing options or our accepted payment methods. 

What are the Risks of Facial Trauma Reconstruction?

Facial trauma reconstruction is not without its risks. Potential complications include injury to the teeth, nerves, blood vessels, salivary glands, eyes, and other vital structures. Other risks include the possibility of infection, bleeding, poor healing of the bone (non-union) or the wound as well as malposition of the bone (malunion), or poorly fitting teeth (malocclusion). To correct these problems, surgery may be necessary. Selecting a board certified surgeon who specializes in cranio-maxillofacial surgery can help reduce the risks involved with facial trauma reconstruction. Dr. Payne has an eye towards reconstructing the skin, soft tissue or fat, and bone alignment along with functional repair of the facial trauma deformity to achieve the best aesthetic outcome possible. The main goal is to restore your facial function and appearance as normally as possible.

Your care, comfort, and results are our highest priorities. To learn more about facial trauma reconstruction and your treatment options, please contact our practice with any questions or to schedule a consultation.