A zygomatic fracture is a break in the cheekbone, usually from a blow to the face, which can flatten the cheek, cause numbness under the eye and upper lip, and affect eye position. About half need no surgery; displaced fractures are repositioned and fixed, often through small or hidden incisions, to restore facial contour and eye support.
- AnaesthesiaGeneral
- DurationTypically 1 to 3 hours
- Hospital stayUsually 1 to 2 days
- Back to routineUsually 1 to 2 weeks for desk work; contact sports after about 6 weeks or as advised
What is zygomatic fractures?
The zygomatic bone (cheekbone) forms a large part of the facial skeleton, giving the cheek its prominence and supporting the eye. Fractures usually follow blunt trauma to the face. Symptoms can include a flattened cheek, altered sensation under the eye and in the upper lip, jaw pain or restricted mouth opening, and bruising. If missed, the fracture can cause lasting cosmetic and functional problems.
Treatment depends on how far the bone has moved and whether underlying structures are damaged. The existing page states that about half of zygomatic fractures need no surgery. Surgery repositions the bone and secures it to the stable surrounding bones. If the orbital walls are disrupted, air can enter the eye socket, causing pain and, rarely, vision problems.
Isolated arch fractures can often be lifted back without large incisions (direct or Gillies approach). Displaced fractures are fixed by open reduction through the upper eyelid or brow, from inside the mouth (upper buccal sulcus), through a lower eyelid (subciliary) incision for the orbital rim and floor, or through a bicoronal scalp incision for comminuted arch fractures.
Who is zygomatic fractures for?
- Displaced cheekbone fractures causing a flattened cheek
- Numbness or tingling of the cheek and upper lip (infraorbital nerve dysfunction)
- Disruption of the eye socket floor
- Restricted jaw movement
- Comminuted fragments pressing on nearby structures
How is it done?
- Before surgery: facial photographs, X-rays or CT and ECG; avoid aspirin and certain herbal supplements; fast for 8 to 12 hours and arrange someone to accompany you
- Closed reduction for fractures that remain stable after being set
- Gillies approach: a small incision in the temple hairline lifts the bone, leaving little or no visible scar
- Open reduction with small plates through upper eyelid or brow, inside-the-mouth, lower eyelid or bicoronal incisions
- Orbital floor repair if the eye socket is involved
What is recovery like?
- Painkillers and antibiotics as prescribed
- Semi-liquid or soft diet initially
- No nose blowing for at least 10 days; keep the head raised
- Mouthwash, lip care and a soft toothbrush for oral hygiene; ice packs for swelling
- Protect incisions from sun and tanning for several months
What are the risks?
- General risks of surgery and anaesthesia
- Residual facial asymmetry or deformity
- Persistent numbness of the cheek or upper lip
- Visible scarring
- Eye problems such as double vision or eyelid position changes after orbital surgery
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
Does a broken cheekbone always need surgery?
No. The existing page notes that about half of zygomatic fractures need no surgery. Undisplaced fractures without eye or bite problems can often heal on their own. Surgery is advised when the cheek is flattened, the eye socket is disrupted, mouth opening is restricted or nerve function is affected.
What are the signs of a fractured cheekbone?
Typical signs are swelling and bruising around the eye, a flattened cheek once swelling settles, numbness of the cheek, side of the nose and upper lip, pain on opening the mouth, nosebleed and sometimes double vision. A CT scan confirms the fracture.
Will cheekbone surgery leave a visible scar?
Surgeons use incisions that are hidden or heal discreetly: inside the mouth, in the temple hairline, in the upper eyelid crease or brow, or just below the lower eyelashes. Most scars become hard to see over time, especially with sun protection.
Why should I not blow my nose after a cheekbone fracture?
Cheekbone fractures often involve the sinuses and eye socket. Blowing your nose can force air into the tissues around the eye, causing swelling and pain. Avoid nose blowing for at least 10 days after injury or surgery, and sneeze with your mouth open.
