The first week after facial fracture surgery is dominated by swelling, by learning to eat again and by keeping the mouth and wounds clean. Most people are surprised by two things: how puffy the face looks on the second and third days, and how much of the recovery depends on small, dull routines rather than anything dramatic. Hospital stays after facial fracture repair are often short, sometimes only a night, so much of this week happens at home. Knowing what is expected and what is not makes it far easier.
What will your face look like in the first few days?
Swelling and bruising usually increase for the first two to three days before turning the corner. Bruising often travels downwards under gravity, so a cheek injury can leave colour along the jaw and neck later in the week. Eyelids can swell enough to close the eye partly, which is alarming but usually settles. The face is often not symmetrical at this stage, and it is far too early to judge the shape of the repair. Cold packs applied over a cloth for short spells in the first day or two, and sleeping propped up on pillows, both help the swelling drain.
How much pain is expected?
Most people describe a dull ache and tightness rather than sharp pain, with soreness around the incisions and, if the jaw was involved, discomfort when opening the mouth. Regular tablets usually control it well. What should not happen is pain that rises steadily after a few days, pain with fever, or new severe pain in an eye. Any of those needs to be reported rather than treated with more medicine at home.
Where will the incisions be?
Surgeons generally hide facial incisions where they will not be obvious. Many cuts are placed inside the mouth, in the upper or lower gum crease, so there is no visible scar. Others sit in a lower eyelid crease, inside the eyelid, in the eyebrow, or in hair bearing scalp. Small plates and screws hold the bone and are usually left in place. In the first week you will have some stitches, either dissolving or ones that need removal, and your team will tell you which you have and when they come out.
What can you eat?
Diet is the part most people underestimate.
- Expect a soft or liquid diet, and follow exactly what your team has advised, since it depends on which bones were fixed.
- If your jaws have been fixed together with elastics or wires, everything must go through a straw or a spouted cup.
- Aim for enough protein and fluid, because healing needs both and appetite is often poor.
- Avoid hard, crunchy and chewy foods, and avoid biting into anything with the front teeth.
- Keep meals small and frequent rather than large, since opening the mouth wide is uncomfortable.
Losing some weight in this period is common. Losing a lot, or being unable to take fluids, is a reason to call the team.
How do you keep the mouth clean?
If there are incisions inside the mouth, oral hygiene is the main defence against infection. Use a soft toothbrush gently on the teeth, avoid brushing directly over the stitches, and rinse with whatever mouthwash or salt water regimen your team has prescribed, especially after every meal. If elastics or wires are in place you will be shown how to clean around them, and you should keep the small cutting tool your team gives you within reach at all times in case of vomiting or breathing difficulty.
What are the other rules for this week?
- Do not blow your nose if a cheekbone, eye socket or upper jaw was repaired, because it can push air into the tissues around the eye. Sneeze with the mouth open.
- Sleep with the head raised on two or three pillows.
- No smoking or tobacco, which slows healing and raises the risk of infection.
- Avoid bending, straining, lifting and any sport or activity where the face could be knocked.
- Wear glasses rather than contact lenses if the eye socket was involved and your team advises it, and keep glasses off the nose if the nose was repaired.
- Take antibiotics and other medicines exactly as prescribed, and finish the course.
When should you call the team urgently?
Some changes should not wait for the next appointment. Contact your surgical team or go to an emergency department straight away if you develop any loss of vision, double vision that is new or worsening, severe or increasing pain in the eye, a rapidly swelling eye, fever with increasing facial swelling and redness, pus or a bad taste from a wound, bleeding that will not stop, clear fluid running from the nose, or difficulty breathing. If your jaws are fixed together and you feel sick or cannot breathe comfortably, treat it as an emergency.
What happens at the first review?
You will usually be seen within the first week or two. The team will check the wounds, your bite, eye movements if the socket was involved, sensation over the face and how far you can open your mouth. Stitches may be removed and X rays or a scan may be repeated to confirm the position of the bones. This is the appointment to raise anything that has worried you, including numbness, a bite that feels wrong or a lump you can feel under the skin. At Elegance Clinic in Surat, written estimates are given before admission, so the cost of reviews and any further imaging can be discussed in advance rather than afterwards.
What comes after this week?
Swelling continues to settle over several weeks, numbness recovers slowly if a nerve was involved, and diet is advanced step by step as the bone unites. The longer arc of recovery, including when the face looks like itself again and when you can return to contact sport, is a separate discussion that runs over months. For this week, the job is simpler: rest, keep clean, eat soft, stay upright and call if something changes.
