Breathing, bleeding & consciousness
Difficulty breathing, uncontrolled bleeding, loss of consciousness, confusion, repeated vomiting, or other concerning symptoms after head injury require emergency assessment.
Facial Trauma
Facial injuries may involve the skin, soft tissues, cartilage, bone, or structures important for breathing, vision, and facial movement. Treatment begins with assessment of the injury and associated medical priorities, followed by an individual plan to restore function and repair damaged tissues where appropriate.
Understand Facial TraumaUnderstanding facial injuries
The injury and associated risks come first.
Facial trauma may result from falls, road traffic accidents, sports injuries, or other causes. An injury that appears limited to the skin may involve deeper structures, while facial fractures may occur alongside head, eye, dental, or other injuries.
Assessment considers the mechanism of injury, symptoms, examination findings, and the need for imaging or specialist evaluation. Airway, bleeding, neurological status, vision, and associated injuries take priority when relevant. Not every facial injury requires surgery, and not every injury can be managed by one specialty.
Repair may aim to restore tissue coverage, alignment, breathing, eye protection, or other functions. Scars, altered sensation, asymmetry, or residual deformity may remain despite appropriate treatment.
Emergency assessment
When to seek urgent medical care.
This website is not an emergency service. New or significant facial injuries should be assessed through an appropriate emergency department when urgent evaluation may be required.
Vision & eye symptoms
Loss or change of vision, severe eye pain, double vision after injury, or suspected injury to the eye or surrounding structures warrants urgent assessment by an appropriate specialist.
Severe or complex injuries
Deep or contaminated wounds, exposed structures, significant deformity, suspected fractures, or injuries involving several body regions may require emergency, imaging, or multidisciplinary care.
Do not delay emergency assessment while waiting for an online consultation response. The appropriate hospital and specialist team depend on the injury and the patient's medical condition.
Individual treatment planning
Function, anatomy, and timing guide the plan.
After urgent priorities have been addressed, assessment considers the structures involved, the degree of displacement or tissue loss, wound condition, previous injuries, and the patient's health. Relevant imaging and specialist findings help determine whether observation, wound care, reduction, repair, or referral is appropriate.
The timing of treatment depends on the injury. Some problems require immediate intervention, while selected fractures or reconstructive procedures may be planned after swelling and associated injuries have been assessed. A fixed timetable is not appropriate for every patient.
Selected nasal fractures
Nasal injuries may affect the nasal bones, septum, airway, and surrounding tissues. Examination considers deformity, obstruction, associated facial injuries, and the possibility of a septal haematoma, which requires urgent assessment. Selected displaced fractures may be treated with closed reduction when appropriate; other injuries may require different management or specialist referral.
Soft-tissue injury & reconstruction
Facial wounds may require cleaning, assessment of tissue viability, repair of deeper structures, and careful closure. Tissue loss, contamination, infection, or injury to nerves, ducts, eyelids, lips, or other important structures may require additional expertise or staged reconstruction.
Treatment approaches
Different injuries require different solutions.
The following approaches are examples, not a complete list of services or a predetermined treatment plan. The appropriate procedure and treating team are determined after clinical assessment.
Wound assessment & repair
Selected wounds may be managed with wound preparation, direct closure, or layered repair. More complex defects may require grafts, local flaps, staged treatment, or referral. Tissue viability, contamination, and preservation of function influence the choice.
Nasal fracture reduction
Closed reduction may be considered for selected displaced nasal fractures. The decision depends on examination, timing, associated injuries, and the condition of the septum and airway. Reduction does not guarantee restoration of the original appearance or breathing.
Complex fracture & specialist care
Some facial fractures require fixation or other specialist management. Injuries involving the orbit, jaws, teeth, or multiple facial structures may require maxillofacial, ophthalmic, ENT, neurosurgical, or other specialist input and an appropriately equipped hospital.
The specific procedures offered by Dr. Joe and the appropriate hospital setting will be confirmed after assessment. This page does not imply that all facial trauma or complex fracture surgery is provided personally.
Recovery & follow-up
Recovery depends on the injury and repair.
Swelling, bruising, discomfort, and temporary changes in sensation may occur after facial injury or surgery. Wound care, dressings, splints, medication, activity restrictions, and follow-up vary according to the structures involved and the treatment performed.
Soft-tissue healing, fracture healing, scar maturation, and recovery of sensation may occur over different timeframes. Some patients require rehabilitation, additional assessment, or later reconstructive treatment. A particular recovery timetable or complete restoration of appearance or function cannot be guaranteed.
Preparation and records
Bring relevant emergency records, imaging, previous operative reports, medication details, and photographs when available. The treating team will advise on preparation, anaesthesia, wound care, and follow-up. Do not stop prescribed medication without clinical guidance.
Concerning changes
New visual symptoms, worsening breathing difficulty, rapidly increasing swelling, uncontrolled bleeding, fever, escalating pain, or concerning wound changes require prompt medical assessment. Follow the treating team's emergency instructions rather than waiting for a routine appointment.
Safety & limitations
Understanding the risks and possible residual effects.
The risks depend on the original injury, associated medical problems, treatment, and the tissues involved. Appropriate treatment may reduce certain risks but cannot eliminate every complication or residual effect.
Wound & surgical complications
Bleeding, infection, delayed healing, wound breakdown, unfavourable scarring, and anaesthesia-related complications may occur. Tissue loss or complex wounds may require additional procedures.
Function & sensation
Residual deformity, altered sensation, persistent breathing problems, asymmetry, or other functional limitations may remain. The risks to vision, nerves, ducts, and other structures depend on the injury and treatment.
Further treatment
Selected fractures may heal with residual displacement or require later assessment. Additional reconstructive surgery may sometimes be considered, but it carries further risks and cannot guarantee the original appearance or function.
Observation, non-surgical management, surgery, or referral may be appropriate depending on the injury. Treatment decisions should reflect medical priorities and informed discussion of alternatives.
Clinical results
Injury and repair in clinical context.
Clinical photographs may illustrate the original injury, treatment, and follow-up. Each case should include the diagnosis, procedures performed, and relevant functional context. Images cannot demonstrate every aspect of recovery or predict an individual's result.
View Patient ResultsFeatured clinical case
BeforeImage pending
AfterImage pending
Clinical photographs and case details will be added here. Injury · Treatment · Follow-up
Surgeon-led care
A considered approach to facial injury.
Dr. Joe Areejunthawat is a board-certified plastic surgeon in Bangkok. His reconstructive approach begins with understanding the injury, the patient's medical condition, and the structures and functions involved.
The treatment plan considers medical priorities, available options, limitations, and risks, with other specialists and appropriately equipped hospital facilities involved when required.
About Dr. JoeYour consultation
Seeking assessment after a facial injury?
For non-emergency concerns, share relevant medical records, imaging, previous treatment details, and photographs when available. Dr. Joe can assess whether further treatment or specialist referral is appropriate. New or urgent injuries should be assessed through an emergency department.