Facial Injuries from Car Accident: When to See a Plastic Surgeon?

Facial contusion and swelling due to a car accident?

Hello Doctor, I was in a car accident last July.
The right side of my face sustained a significant impact, resulting in extensive bruising and swelling on my cheek.
After two days, it started to turn purple.
Now, there are no visible bruises, but I still feel a foreign sensation in my cheek.
When I smile, my face appears asymmetrical.
Pressing on my cheek and zygomatic bone causes a tingling sensation and mild pain.
There is also a small hard lump when I pinch my cheek.
Should I see a plastic surgeon for this?

Lin Zhi-Yu, 20~29 year old female. Ask Date: 2023/05/15

Dr. Lu Daokuan reply Plastic Surgery

It requires a professional assessment.

Reply Date: 2023/05/15

More Info

After a car accident, facial injuries can lead to various complications, including bruising, swelling, and potential structural damage to the bones and soft tissues of the face. Given your description of symptoms such as persistent asymmetry, a foreign body sensation, and localized pain in the cheek and zygomatic area, it is advisable to consult a plastic surgeon or an oral and maxillofacial surgeon. These specialists are trained to assess and manage facial injuries, particularly those involving the bones and soft tissues of the face.

In your case, the presence of a hard lump in the cheek area could indicate several possibilities, including scar tissue formation, hematoma (a localized collection of blood outside of blood vessels), or even a bone fragment that has not healed properly. The ongoing discomfort and the sensation of numbness or tingling (often described as "pins and needles") could be due to nerve involvement, which is not uncommon in facial injuries.
Here are some key points to consider regarding your situation:
1. Assessment by a Specialist: A plastic surgeon will perform a thorough examination, which may include imaging studies such as X-rays or CT scans to evaluate the extent of any bone fractures or soft tissue injuries. They will also assess the cosmetic aspects of your injury and discuss potential treatment options.

2. Treatment Options: Depending on the findings, treatment may range from conservative management, such as physical therapy and pain management, to surgical intervention. If there are significant structural issues, such as misaligned bones or persistent hematomas, surgical correction may be necessary.

3. Scar Management: If there are concerns about scarring, especially given the bruising and swelling you experienced, the surgeon may recommend treatments to minimize scar formation. This can include silicone gel sheets, massage therapy, or even laser treatments in the future.

4. Follow-Up Care: Regular follow-up appointments will be crucial to monitor your healing process. If you notice any changes in sensation, increased pain, or other concerning symptoms, it’s important to report these to your healthcare provider promptly.

5. Physical Therapy: In some cases, physical therapy may be recommended to help improve facial symmetry and function, especially if there are issues with muscle control or nerve function.

6. Psychological Support: Lastly, it’s important to address the psychological impact of facial injuries. Many individuals experience anxiety or distress related to changes in their appearance. Counseling or support groups can be beneficial in coping with these feelings.

In conclusion, given your symptoms and the history of trauma, seeing a plastic surgeon is a prudent step. They will provide a comprehensive evaluation and guide you through the best course of action for your recovery. Remember, timely intervention can significantly improve outcomes and help restore both function and aesthetics to your facial structure.

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