Cheek Fracture Repair in NYC

The cheek bones — anatomically called the zygomatic bones — play a critical role in the structure of the face. They give the midface its characteristic projection and contour, and they also support the eye socket directly above. Unfortunately, because of their prominent position on the face, the cheek bones are among the easiest facial bones to fracture. Most cheek fractures result from impact injuries — auto accidents, sports injuries, falls — but they also occur frequently after physical assault. Once the cheek bone is fractured, the resulting displacement can distort the visible shape of the face and allow the eye socket above to drop downward, producing both aesthetic and functional consequences. Cheek fracture repair is one of the procedures within facial reconstructive surgery at Dr. Khosh’s Park Avenue practice in New York City. Left to heal on its own without surgical intervention, a displaced cheek fracture often produces permanent changes to facial shape and orbital position that become very difficult to correct later.

A cheek bone fracture rarely affects only the cheek itself — the structural role of the cheek bone extends to the eye socket above and the visible facial contour, which means the consequences of inadequate repair can extend well beyond the original fracture site. Dr. Maurice Khosh’s three decades of facial trauma reconstruction cover the precise hardware placement, hidden incision techniques, and three-dimensional bone repositioning that cheek fracture repair requires. Dual board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery, and a former member of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Board Examination and Continuing Education Committees, Dr. Khosh is a Fellow of the American College of Surgeons (FACS). He has been recognized as a perennial Castle Connolly Top Doctor and a Best Doctors in America honoree.

How a Cheek Bone Fracture Affects the Face

The cheek bone’s central position in the midface anatomy means a fracture can affect several structures simultaneously:

• Facial Contour Flattening: A displaced cheek bone produces a visibly flatter or asymmetric midface, often noticeable from the front view and even more obvious from above
• Eye Socket Descent: Because the cheek bone forms the lateral and inferior walls of the eye socket, a fracture can allow the eye position to drop downward — a condition called enophthalmos
• Visual Disturbances: Eye socket changes can produce double vision (diplopia), particularly when looking upward, by altering the position and function of the eye muscles
• Numbness in the Mid-Face: The infraorbital nerve runs along the cheek bone; fractures often produce numbness or tingling across the cheek, side of the nose, and upper teeth
• Jaw Function Limitation: Severe fractures can impinge on jaw movement, producing pain or restriction when opening the mouth
• Asymmetric Facial Appearance: Even subtle displacement of one cheek bone produces visible facial asymmetry compared to the unaffected side

Common Causes of Cheek Bone Fractures

Most cheek fractures share a common mechanism — significant direct force applied to the prominent cheek area:

• Motor Vehicle Accidents: Impact against the steering wheel, dashboard, or window during car accidents
• Sports Injuries: Contact sports such as football, hockey, baseball, basketball, and martial arts where blows to the face occur
• Falls: Particularly falls onto a hard surface where the cheek bone takes the brunt of the impact
• Physical Assault: Cheek bones are common impact sites in physical altercations
• Workplace Accidents: Industrial accidents involving falling objects or machinery
• Pedestrian and Cycling Accidents: Impact injuries involving direct trauma to the face

When Cheek Fracture Repair Is Necessary

Not every cheek fracture requires surgical repair. Surgical intervention is typically indicated when one or more of the following findings are present:

• Visible Facial Asymmetry: Displacement of the cheek bone that produces a noticeable change in facial contour
• Eye Socket Involvement: Any fracture extending into the orbital floor or walls that affects eye position or function
• Double Vision: Diplopia indicating that the eye muscles or eye position has been affected
• Sensory Nerve Compression: Persistent numbness or pain from infraorbital nerve compression by displaced bone fragments
• Jaw Movement Restriction: Fracture fragments impinging on the path of jaw motion
• Cosmetic Concern: Patients who notice and want correction of even subtle facial asymmetry following the injury

For non-displaced fractures with no functional consequences, conservative management with close monitoring may be appropriate.

How Cheek Fracture Repair Surgery Works

Cheek fracture repair involves repositioning the displaced bone segments back to their original anatomical position and stabilizing them with small titanium plates and screws while the bone heals. Dr. Khosh’s approach to cheek fracture repair:

• Three-Dimensional Bone Repositioning: Each displaced segment is precisely repositioned to restore the original three-dimensional anatomy — not just the visible outer contour but the bone’s relationships with the eye socket, jaw, and surrounding facial structures
• Titanium Plate and Screw Fixation: Small, biocompatible titanium plates and screws are used to stabilize the bone segments in their correct position; the hardware remains permanently in place and does not need to be removed in most cases
• Multi-Point Stabilization: Depending on the fracture pattern, fixation may be required at multiple anatomical points to ensure stability during the healing process
• Orbital Floor Reconstruction: When the fracture extends into the orbital floor, the floor may need to be reconstructed using a thin titanium mesh or biocompatible material to support the eye properly
• General Anesthesia: The procedure is performed under general anesthesia at an accredited surgical facility, typically as an outpatient procedure

“Cheek fracture repair is one of the procedures where the timing of treatment matters significantly. In the first one to two weeks following the injury, the bones are still mobile enough to be repositioned with relative ease. After several weeks, the fracture begins healing in its displaced position, and correction requires more involved surgery — sometimes re-breaking the bones to allow proper repositioning. The first conversation I have with most cheek fracture patients is about how soon we can see them, because the window for the simpler procedure is finite.” — Dr. Maurice Khosh

Hidden Incision Approach for Cheek Fracture Repair

One of the most important refinements in modern cheek fracture repair is the use of hidden incisions — surgical access points that leave no visible facial scarring after healing:

• Lower Eyelid Approach: A small incision placed just below the lashes of the lower eyelid (the “subciliary” approach) allows access to the cheek bone and orbital floor while healing to a virtually invisible line
• Intraoral Approach: An incision made inside the upper mouth (along the gum line) provides access to the front and side of the cheek bone with no external scarring whatsoever
• Temporal Approach: For fractures requiring access to the upper lateral cheek, a small incision hidden within the temple hair can provide access
• Multi-Incision Strategy: For complex fractures requiring access from multiple angles, several hidden incisions may be used in combination — each individually small and well-concealed

Cheek Fracture Repair Recovery

Cheek fracture repair surgery typically takes one to three hours depending on the complexity of the fracture and whether orbital floor reconstruction is required. Most patients return home the same day. Bruising and swelling are most pronounced during the first one to two weeks, with significant resolution over the following four to six weeks. Most patients return to non-physical work within ten to fourteen days. Eye-related changes from the fracture (double vision, eye position) typically improve substantially in the first weeks after repair, though full neurosensory recovery of the infraorbital nerve can take three to six months in some patients. Most patients see the final functional and aesthetic result by three to six months after surgery.

Why Choose Dr. Khosh for Cheek Fracture Repair

• Three Decades of Facial Trauma Reconstruction: Refined expertise in hardware-based repair of facial fractures
• AAFPRS Standards-Setting Service: Former member of the American Academy of Facial Plastic and Reconstructive Surgery Board Examination and Continuing Education Committees
• Hidden Incision Technique: Surgical access through the lower eyelid, mouth, or temple to leave no visible facial scarring
• Functional and Aesthetic Integration: Repair planned to address both visible facial contour and functional anatomy (eye position, nerve function, jaw movement)
• Dual Board Certification: Combined facial plastic and head and neck surgery expertise
• Park Avenue Convenience: Private Upper East Side practice serving patients from across Manhattan and the tri-state area

Schedule Your Cheek Fracture Consultation in NYC

If you or a loved one has suffered a cheek bone fracture — whether recent or healed in a displaced position from an injury years ago — the first step is a thorough evaluation of the specific fracture pattern, any associated eye-socket or nerve involvement, and a discussion of the appropriate surgical approach. Contact our office in Manhattan to schedule a private consultation with Dr. Khosh at his Park Avenue office, or call (212) 339-9988.