Removal of Metal Plates from Face?

Assaulted 6 months ago. Saw awful surgeon outside of seattle to fix facial fractures including zygomatic break. Have mesh under eye due to full blow out. Butterfly next to nose touches nerves in teeth - driving me nuts, also looks permanently swollen. Large chunk of bone was removed from there. Can butterfly be replaced by anything else or better positioned? Butterfly in upper jaw also needs to be removed as I can touch it above my teeth, also painful. What kind of doc should I go to?

Doctor Answers 7

Problems following major facial fractures

Thanks for your question and I'm sorry to hear of the problems you've been having.

To answer your specific question about what kind of doctor should you go to, the short answer is: you should go to someone who specialises in post traumatic facial reconstruction - whether that be a plastic surgeon, facial plastic surgeon, maxillofaciallosurgeon, craniofacial surgeon, whoever. I am a plastic surgeon so I am biased towards my own discipline, but you need someone good to handle your revision case.

In terms of what needs to be done, you will need imaging, such as CT, to determine where things are. Your surgeon will then make a plan to get things to where they should be - removing plates/ performing osteotomies (cut the bones)/ bone grafting (taking bone from elsewhere to place in any bony defects)/ putting things back where they should be and then holding them there with plates and screws.

Nerve damage is often a consequence of the initial injury and not the treatment, so there are no guarantees of cure there. Sometimes medications can help with this. The swelling following revision facial trauma surgery is often worse than that associated with the original injury.

Good luck with your treatment and I hope this helps.

Serious facial injury

You have certainly had a very serious facial injury requiring multiple plates and fixation. As healing goes on however, many of these plates can be removed safely after there is evidence that the bone itself has healed. In your community, a number of doctors can address many complex facial fractures with plates, including plastic surgeons. Sometimes oral and maxillofacial surgeons and ear, nose and throat surgeons also can treat patients with facial fractures and similar deformities.

Joseph Hunstad, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 43 reviews

Facial Fractures Plates Can Be Removed -Pain May Or May Not Get Better

Just like the way they were put in, your metal fractures plates and screws can be removed. The 'butterfly' plates to which you refer are either mesh screen-type plates or double-Y shaped plates which are common facial fracture repair devices. Sometimes they can cause pain if they are closely placed to the infraorbital nerve which is often necessary in complex facial fractures. Ar this point, it is reasonable to have them removed and see if your symptoms improve. You may also have chronic nerve and facial pain from the original injury in which the removal of these fixation devices may offer little improvement in your symptoms.

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Post-trauma plate sensitivity.

After any major craniofacial trauma, a surgeons job is to put a patient back together as best as possible. This may involve plating and screw systems designed to align fracture and/or misplaced bones until they heal. Within six months, they are stabilized and any plates can be removed. 

In the bigger picture, many trauma patients need multiple surgeries to be returned to as normal as possible. Unfortunately your case is not unique, but rest assured that evaluation and treatment by the appropriate surgeon which may include a plastics, craniofacial, ENT, or oculoplastics surgeon will be of benefit.

Carlo Rob Bernardino, MD
Monterey Oculoplastic Surgeon
3.0 out of 5 stars 2 reviews

Repair of Facial Fractures

Repair of facial fractures is technically difficult. The plates and screws hold the bones in position while they heal. If you see a board certified plastic surgeon or oral & Maxillofacial surgeon the can be removed without replacement. The bone should be healed now. Good luck. Dr. ES

Removal of reconstruction plates

The plates that are used to hold the bones in place as they heal rarely need to be removed. However, the plates can sometimes cause problems and if they are causing trouble, they can be removed after about 6 months in most cases.  I would suggest you get evaluated by a surgeon with an interest and expertise in taking care of facial trauma to evaluate you, because not all surgeons have that interest.  Good luck!

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Facial Fracture

You sound to have sustained a multiple major facial fractures.

I do not believe yu can blame the treating doctor for all your problems. You had a major truama and multile facial fractures. ay one of these can give you chronic pain nad discomfort. Your anger should be directed at the reason you had such a major trauma.

Fracture zygoma, blow out fracture and mandibular fractureand nasal fracture, that means almost every bone in your face was affected. You had plate fixation, and plates come with a certain thickness, that is why over thin areas they show as swelling.

The pain is probably due to nerve injury due to the trauma.


Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.