At this level the entire facial skeleton comes loose from the skull. The break travels through the root of the nose, across both eye sockets to the outer rims, and through the arches towards the ears, so nose, cheekbones and jaw move as one.
A Le Fort III fracture, also called craniofacial disjunction, separates the whole face from the skull base. Unlike the lower levels, the cheekbones and the eye socket outer walls come away too, so the face can lengthen and flatten as a unit. Treatment stabilises the patient first, then reattaches the facial framework to stable skull bone and restores the bite.
The face hangs from the skull at a small number of strong junctions. In this pattern every one of them fails. From the root of the nose the fracture passes back through the inner and outer walls of each eye socket, comes out at the outer rim beside the eyebrow, and continues through the arch that runs towards the ear. Below that line the whole face, including the nose, both cheekbones and the tooth bearing jaw, is no longer joined to the skull.
The consequences are visible and immediate. A longer, wider face pushed backwards is typical, the eyes may look sunken, and holding the upper teeth moves the entire face including the eye socket rims. Swelling is severe, both eyes bruise heavily and the bite is deranged. Because the injury sits against the skull base, bleeding, a leak of fluid from around the brain, and damage to the eyes or the brain itself are all real concerns.
This is therefore a hospital emergency long before it is a reconstructive problem. Airway, bleeding and head injury come first, imaging follows, and surgery is timed to when the patient can safely tolerate a long operation.
Every displaced injury at this level needs reconstruction. The real question is timing, and that depends on how stable the patient is overall.
The airway is protected, bleeding is controlled and head, neck and chest injuries are assessed. Facial repair waits until these are settled, which may take several days.
A computed tomography scan maps every separated junction and shows the eye sockets and skull base. The plan names which points will be exposed and in what order they will be fixed.
Surgery begins from bone that is still attached to the skull, usually at the outer rim of the eye socket and the nasal root. The facial frame is hung back onto that foundation.
The upper and lower teeth are brought into their earlier relationship and held, which sets the vertical height of the face and guides the position of the midface pillars.
Plates are placed at the reattached junctions and along the pillars. Many patients spend the first days in intensive care, with eye and neurological checks continuing throughout.
Care is centred on breathing, swelling and pain control, often in intensive care. The face and eyelids are markedly swollen and nutrition is given in liquid form.
Swelling begins to fall and stitches are removed. Eye assessment is repeated, and speech, swallowing and a soft diet are gradually reintroduced.
The framework has united. Diet advances, walking and light activity resume, and the shape of the face becomes clearer as the last swelling goes.
Sensation, eye position and the bite are reviewed properly. Refining procedures on the nose, eye socket or teeth may be planned once everything is settled.
This is one of the largest injuries the face can sustain, and honesty matters more than optimism. Careful reconstruction restores much of the shape and a working bite for many patients. Even so, some flattening, a wider nasal root, differences in eye level or lasting numbness can remain. Recovery can vary widely, and further staged surgery is often part of the plan rather than a sign that something went wrong.
Both the injury and the surgery carry significant risks, and these are discussed with the family in full before consent.
Recovery continues for months after discharge, and steady routines protect what was rebuilt in theatre.
Life threatening problems come first. Facial reconstruction is timed to when the patient can tolerate a long operation, which is usually a few days after the injury.
The main operation restores the framework and the bite. Refinements to the nose, eye sockets or teeth are frequently planned afterwards as staged work.
Fracture lines run through both eye sockets at this level. Vision, eye movement and eye position are checked before, during and after the repair.
Most plates stay in place without trouble. Removal is considered only if a plate becomes uncomfortable, infected or noticeable under thin skin.
Severe facial injuries at Elegance Clinic in Surat are managed as one continuous plan, with the emergency phase, the reconstruction and any later refinement followed by the same plastic surgery team.
Cost at this level depends heavily on the whole injury picture, including intensive care, the number of sites fixed, hardware, theatre time and the length of stay. Jaw fracture fixation offers the nearest reference band and is shown below as a guide to the surgical component. A written estimate is prepared once the patient is stable and the plan is set. Such admissions are usually covered by mediclaim, and the team helps with the paperwork.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →The surgical component usually sits in a band of Rs 55,000 to Rs 1.2L, while the overall total depends on intensive care, imaging, hardware and length of stay. A written estimate is shared with the family once the patient is stable and the plan is agreed.
Accident related facial reconstruction is covered by most mediclaim policies, as it is reconstructive and not cosmetic care. The claim needs accident records, scan reports and operative notes. Room rent limits and waiting periods in the policy still apply.
Surgery is timed to when the patient can tolerate it, with the airway protected and other injuries controlled first. Risks are real and include bleeding, infection, vision problems and fluid leak from around the brain, and all are explained beforehand.
The hospital stay is often a week or more, and swelling takes several weeks to settle. Bone unites by about six weeks, while full recovery is measured in months and depends on head, chest and other injuries as much as on the face.
Careful reconstruction restores much of the shape and a working bite for many patients. Some flattening, a wider nasal root, differences in eye level or lasting numbness can remain, and staged refinement is often part of the plan.
Only in the rare case where nothing has moved and the bite, eyes and facial height are normal. A face that is mobile against the skull base needs fixation, otherwise it heals long, flat and out of position.
Usually within the first one to two weeks, once bleeding, breathing and any head injury are under control. Operating too early risks the patient, while waiting too long allows the fragments to fuse in the wrong place.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
