Total and Delayed Reoperation of Panfacial Fracture Due to Poor Aesthetic and Functional Results

Complex facial fractures, when managed without adhering to basic principles of reduction and fixation, can have disastrous consequences for facial soft tissues. This article presents the case of a patient with functional and aesthetic impairments secondary to panfacial fracture sequelae. The proposed treatment plan involved a total reoperation of the panfacial fracture, including bilateral orbital repositioning, orthognathic surgery to correct traumatic occlusal sequelae, and bilateral internal orbital reconstruction. Despite improvements in mandibular width, facial projection, orbital positioning, and consequent globe position, as well as the achievement of stable and functional occlusion, the final result is not of the same quality as it would have been if performed correctly in the first surgery. Total reoperation of a panfacial fracture, including orbital reconstruction and orthognathic surgery, is effective from an aesthetic and functional standpoint but is not equivalent to a single, early, and correct surgical approach.