Our Services
Facial Trauma
Primary and complex secondary treatment of facial fractures — from isolated mandibular injuries to pan-facial trauma — delivered by two surgeons with unparalleled experience at the Royal London Hospital, the UK's busiest Major Trauma Centre.
Understanding the Condition
What Is Facial Trauma?
Facial trauma refers to any injury to the bones, soft tissues, and structures of the face. It may result from road traffic accidents, workplace incidents, sport, assault, or falls. Injuries range from isolated fractures of a single bone to complex pan-facial trauma involving multiple facial zones simultaneously.
The face is anatomically intricate: the bones of the upper jaw, cheeks, nose, eye sockets, and lower jaw interact closely with the teeth, the eyes, and the brain. Facial trauma therefore requires surgeons with a thorough understanding of this anatomy, the ability to plan complex reconstructions, and the experience to achieve the best possible functional and aesthetic outcome.
Mr Bhatti and Professor Holmes treat over 1,000 acute trauma cases per year at Barts Health NHS Trust and the Royal London Hospital, one of only a handful of centres in the UK capable of managing the full spectrum of facial trauma in a single team. They are featured in the BBC documentary series Critical: Between Life and Death, following the Royal London trauma teams.
Types of Facial Fracture We Treat
- Mandibular (lower jaw) fractures — including condylar, subcondylar, and body fractures
- Midface fractures — Le Fort I, II, and III patterns
- Zygomatic (cheekbone) fractures and zygomaticomaxillary complex injuries
- Orbital fractures — floor, medial wall, roof, and rim
- Frontal sinus and anterior skull base injuries
- Nasal and naso-orbito-ethmoid (NOE) fractures
- Dentoalveolar trauma — injuries to teeth and supporting bone
- Soft tissue injuries — lacerations, degloving, and avulsion
Treatment
Our Approach to Facial Trauma
Treatment is tailored to the nature and severity of the injury, your overall medical condition, and the timing of presentation. Mr Bhatti and Professor Holmes work within a multidisciplinary trauma team at the Royal London Hospital, collaborating with neurosurgeons, ophthalmologists, ENT surgeons, and specialist anaesthetists where required.
Acute (Primary) Treatment
Acute facial fracture surgery is performed as soon as the patient is medically stable, using open reduction and internal fixation with titanium plates and screws. Advanced digital planning tools are used to guide accurate repositioning of fractured segments and restoration of normal bite relationships.
Secondary & Reconstruction
Patients who were not treated acutely, or whose injuries were initially managed conservatively, may present weeks or months later with residual deformity, asymmetry, or functional problems. Secondary reconstruction — including orbital re-exploration, zygomatic repositioning, and scar revision — is a particular strength of this practice.
Research-Led Practice
Our surgeons actively publish research into facial trauma outcomes, including one of the world's largest studies of orbital fracture repair and pioneering work on midface fracture fixation technique. Their research directly informs their surgical practice — and is cited internationally.
“Facial trauma surgery is as much about restoring what a patient had before as it is about technical execution. We measure success not just by whether the plates are in the right place, but by whether the patient can eat, see, breathe, and feel confident again.”
— Mr Nabeel Bhatti
For acute trauma, our team can often arrange urgent assessment. For secondary reconstruction consultations, please contact us directly.