Oral and maxillofacial surgeons, because of their training, are uniquely qualified to evaluate and treat all injuries of the face, mouth, and jaws. Dr. Sultan has extensive experience in this area. He currently serves as one of the main consultants at both Broward General Medical Center and Holy Cross Hospital. Treatment of the trauma patient is a multidisciplinary approach and Dr. Sultan has served on numerous trauma care teams at Level 1 trauma centers.
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Fifty years ago, a handful of Swiss surgeons joined together to champion revolutionary techniques of plating the facial bones to facilitate bone healing with unheard-of results. The group expanded the practices and philosophies of their techniques all over the world.
There are many causes for facial injury:
- Motor vehicle accident
The Arbeitsgemeinschaft fur Osteosynthesefragen (Association for the Study of Internal Fixation, or AO/ASIF) is a global organization synonymous with excellence in surgical techniques and advancing patient care.
Dr. Sultan, because of his extensive experience in these techniques, has been elected to the faculty of this select group of surgeons.
Whatever the reason, injuries to both hard and soft tissues can and do occur. There are over a dozen different bones in the facial skeleton. Common fractured bones in the face include the lower jaw (mandible), upper jaw (maxilla), cheekbone (zygoma) and eye socket (orbit). It is common for patients to present with fractures of more than one bone. Sequencing the repair of multiple facial fractures takes a keen mind in order to form a 3-dimensional picture of the injury and plan the surgery. Modern advances in bone healing have lead to the development of rigid internal fixation. By utilizing rigid plates and screws, fractures can be repaired in a stable and predictable manner, many times not requiring the need for wiring the jaws shut.
Cosmetically designed incisions tend to mask the location of the repair. In many cases incisions can be hidden either inside the mouth, or within the hairline or eyelid. If bone is missing or lost due to severe injury, reconstruction can be accomplished with either natural bone or artificial substitutes. Isolated lacerations are meticulously repaired in order to achieve a minimally detectible result.
The end result is to return the patient to as close a functional and esthetic condition as was present prior to the injury.
Injuries to the teeth include:
- Broken teeth and/or surrounding bone
- Mal-aligned teeth
- Misplaced (avulsed) teeth
Prompt evaluation is important in treatment. Individual teeth should be repaired if possible. Mal-aligned teeth are repositioned and stabilized. Misplaced teeth must be kept in a special environment, and placed back in the tooth socket and stabilized as quickly as possible. If teeth are lost, dental implants can be placed.
If you should be involved in any dento-facial injury, please call our office or present to the nearest emergency room as soon as possible!!
What are the different types of facial injuries?
Facial injuries include injuries involving the mouth, face, and jaw. These injuries run the gamut — everything from deep lacerations to broken teeth and broken facial bones. Bone fractures can occur in the lower or upper jaw, palate, cheekbones, and eye sockets. Cuts and lacerations occur, as you would expect, across the entire facial area.
These injuries are often the result of automobile crashes, sports or recreational activities, fights or assaults, work-related tasks, accidental falls, or even household tasks.
How do I find the best facial treatment option for me?
These are typically emergency procedures when the injuries occur. But once the patient is stabilized, the next step is to see a surgeon to repair the damage. It’s important to find the highest level of expertise, as these injuries have the potential to cause permanent disfigurement and loss of function.
Treatment aims to repair the face’s natural bony architecture and to minimize any lasting scarring. Fractures may be repaired with metal plates and screws; some may need to be wired into place. Bone grafting may be necessary.
These injuries need the experience of an oral and maxillofacial surgeon, as they have the necessary training and experience to handle these injuries. Why are they specially qualified? In addition to their education and clinical experience, oral and maxillofacial surgeons such as Dr. Sultan undergo a rigorous written and oral examination given by the American Board of Oral and Maxillofacial Surgery. These are the requirements necessary to receive board certification from the American Board of Oral & Maxillofacial Surgery.
What are the benefits to having an oral and maxillofacial surgeon treat my facial injuries?
While facial injuries are not usually life-threatening, they always have the potential to cause disfigurement and disability. There can be a loss of function. The resulting scarring can cause long-term emotional issues.
The benefit of having an expert such as Dr. Sultan address your facial injuries is the expectation of a great outcome.
With his extensive experience with all sorts of facial trauma, the odds are he’s already faced exactly the damage that you’re presenting with your injury. That dramatically increases the chances of a structural and cosmetically pleasing end result.
You can’t discount issues such as residual scarring. Dr. Sultan has the experience with both facial and oral surgery to be able to hide incisions within the mouth, the hairline, even the lower eyelid. His goal is to ensure your end results achieve the highest possible combination of function and aesthetics.
Can facial injuries heal without treatment?
Once the initial injury has been addressed, these injuries can heal on their own. Say you fall off your road bicycle and receive a serious laceration on your cheek and other areas of your face. Yes, the clinicians in the emergency room will stem the blood loss and close the injury with sutures. But their goal is to stop the immediate damage, not to be concerned about long-term issues such as scarring or even nerve damage.
But, while your injury may be healed, the odds of it creating lasting disfigurement or even loss of function are high. That’s why you need to see a specialist such as Dr. Sultan for long-term repair and cosmetic issues surrounding facial injuries.
What kinds of symptoms and issues will accompany facial injuries?
Fractures of facial bones will involve bruising, swelling of the surrounding tissues, and pain. Fractures of the nose, the base of the skull, or maxilla can lead to profuse nosebleeds that are difficult to fully close initially. Nasal fractures will also cause extensive swelling across the eyes and cheeks, as well as bruising around the eyes that then descends into the cheeks.
Signs such as a sunken cheekbone or teeth no longer in alignment point to the broken underlying bone. There can be an asymmetry between the sides of the face due to damaged nerves that didn’t fully recover. Nerves and muscles trapped by broken bones need to be put back into their proper positions quickly to avoid permanent damage.
Jaw fractures will create pain with any movement or the mouth, and the patient may have numbness in their lips and chin.
How long will facial injuries take to heal?
There is a wide variation with these injuries and healing times. Here are a couple of general timeframes. It may take 5 to 7 days for the swelling to resolve for the most part. Bruising will take two weeks, sometimes longer, for more involved injuries. Stitches placed are usually removed after one week.
Full healing may take months.
What Is Maxillofacial Trauma?
Maxillofacial trauma is any injury to the face or jaws. These injuries run the gamut: skin lacerations, burns, fractures of the jawbone, obstruction of the nasal cavities or sinuses, damaged eye sockets, and missing or broken teeth.
How Common Is Maxillofacial Trauma?
There are over 3 million cases of facial trauma admitted to emergency rooms each year in the U.S. The most common causes are sports, car accidents, workplace accidents, penetrating injuries, and physical violence.
These involve all the symptoms you would assume, from excessive bleeding to pain, swelling, and numbness. Facial fractures may create difficulty breathing, speaking, or seeing. These can become life-threatening situations, including brain injury.
How Do Facial Fractures Heal?
As a board-certified oral and maxillofacial surgeon, Dr. Sultan has extensive training and experience with all types of facial surgery and repair. With facial fractures, there is a wide divergence of damage as well as surgical options to repair it.
Dr. Sultan may perform a closed reduction, where the broken bones are set without surgery, or he may need to do an open reduction, making an incision in the facial skin to access the bone and reposition the fractured bones.
With broken bones in the nasal area, he may use endoscopy, where he uses an endoscope to see inside the sinuses and even the eye sockets.
Often, internal fixation is necessary to keep the repositioned bones in place. For open reduction and internal fixation Dr. Sultan attaches wires, screws, or plates to the bone surface to preclude any movement as the bones heal.
Is Facial Plastic Surgery To Repair Damage From Maxillofacial Trauma Covered By Insurance?
All portions of this surgeries are covered by insurance. Unlike cosmetic plastic surgery, plastic surgery to help a patient regain a normal appearance is deemed necessary.
How Long Can I Expect A Facial Fracture To Take To Fully Heal?
The time it takes for the bones to fully heal varies, depending on the severity. For cheek fractures that Dr. Sultan sets with plates and screws, it will take approximately six weeks for the cheekbones to heal completely.
Once Dr. Sultan is able to see the extent of your damage, he can give you a much more informed estimate on how your healing after surgery will progress.
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Everyone in this office is friendly, helpful, and professional. Dr. Sultan is a very competent and kind oral surgeon. He immediately made me feel at ease, and explained how he could help. He completed the procedure quickly and painlessly, and the office followed up afterward to make sure my recovery went well. Cannot recommend highly enough.
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