[Royal_Madnessty]

A 30-year-old white woman was the victim of severe facial trauma stemming from a rollover automobile accident after the driver had lost control of the vehicle. It was a small automobile not equipped with airbags and was transporting five passengers. The patient was on the back seat and was not wearing a seatbelt.

One of the individuals involved in the accident reported that no passenger had been ejected from the vehicle, but this did not appear to be true, considering the degree of exogenous contamination of the wounds and the precise characteristics of the borders of the injury, which suggested high impact with a hard object on the street, such as a guard rail. The other passengers suffered minor injuries. The patient was initially taken to a low-complexity hospital for primary care, which included a tracheostomy. 9 h after the accident, she was admitted to the trauma unit of a high-complexity hospital.

On initial evaluation, the patient was conscious, oriented, pale, tachypneic, tachycardic and tracheostomized and had a cranial tomogram revealing no neurosurgical lesions. Physical examination revealed severe facial trauma with a broad laceration–contusion injury with a high degree of contamination (sticks, grass, sand and food scraps). The injury extended from the right parotid-masseter region, contoured below the chin and terminated in the left temporal region, forming a large flap with the entire area of the face. Several tissue layers were involved, along with nearly the entire maxilla, which was attached by its vestibular mucosa alone.

The intensity of the trauma caused the avulsion and destruction of anatomic structures, resulting in complex fractures in the upper and middle thirds of the face. The fronto-naso-ethmoidal regions suffered substantial bone loss. The zygomatic-orbital complex suffered bilateral damage to the medial walls and orbital floors. A transverse fracture extended through the palatine process, with the breakage of the greater palatine arteries, resulting in the partial interruption of the blood supply to the maxilla, which was maintained by a vestibular vascular pedicle and separated from the rest of the facial skeleton ( Fig. 1 ). No damage to had occurred to the patient’s vision, subsequently confirmed by routine ophthalmological examination.

[Hogmann]

So that's a face transplant in in the last photo?

[Karl K]

Yep good question

[mr_feelgood]

Nice post
Pretty fuxkin cool

[Overlord86]

Originally Posted by Hogmann ↗

So that's a face transplant in in the last photo?

That is her own face. They cleaned it out, flapped it back over into position, then stitched it up.

Avulsion of the facial structure like that is common in some face lift surgeries.

[kellyhound]

That's some nasty maxillofacial degloving

[rheedork]

Bloody amazing job they did but I got caught up on the part where she was described to have looked pale upon arrival. How does that work?

[FavaBeans]

Did she die?

[mmansfield]

I rather would have died. Any what's with the "white woman" bit? What does that have to do with anything?

[winvens]

Damn. Props to the medical team. How do they even intubate these kinds of cases let alone manage to sew her degloved face back on?