The cheekbone, medically known as the zygomatic bone, forms the prominence of the cheek and contributes to the structure of the eye socket. This bone defines facial contours, supports muscles for facial expressions, and protects underlying nerves and blood vessels. Understanding the initial steps to take after an impact to this area is important.
Immediate First Aid
After an impact to the cheekbone, immediate self-care can help manage discomfort and reduce swelling. Begin by applying a cold compress, such as an ice pack wrapped in a thin cloth, to the affected area. This application should last for 10 to 20 minutes at a time, repeated hourly for the initial 24 to 48 hours. Cold temperatures constrict blood vessels, reducing both swelling and pain.
Keeping your head elevated, particularly when resting or sleeping, can also minimize fluid accumulation in facial tissues. Propping your head with extra pillows helps promote drainage and further reduces swelling. For pain management, over-the-counter acetaminophen is generally suitable. While NSAIDs like ibuprofen alleviate pain and inflammation, acetaminophen is often preferred for facial bruising as NSAIDs might thin the blood, potentially worsening a bruise.
Avoid applying direct pressure or rubbing the injured cheekbone, as this could exacerbate the damage. Similarly, refrain from applying heat to the area immediately, as this can increase swelling.
Recognizing When to Seek Medical Attention
While minor impacts to the cheekbone might only result in bruising and swelling, certain symptoms indicate a need for professional medical evaluation. Seek medical care if you experience severe or worsening pain in the cheekbone area.
A visible change in facial contour, such as a flattened cheek or an uneven appearance, suggests a possible fracture of the zygomatic bone. Additionally, any changes in vision warrant immediate medical attention. These can include double vision, blurred vision, difficulty moving your eye, or a sunken or bulging eyeball. Such visual disturbances can signal a fracture of the eye socket (orbit) or potential entrapment of eye muscles.
Numbness or tingling sensations in the cheek, upper lip, or side of the nose are also concerning. This symptom indicates potential damage to facial nerves, particularly branches of the trigeminal nerve. Persistent bleeding that does not stop with direct pressure, or profuse bleeding from the nose or mouth, should also prompt an immediate medical visit.
Difficulty opening your mouth fully, or pain when moving your jaw, might suggest a fracture affecting the jaw or connections to the cheekbone. Furthermore, any signs of a concussion should lead to medical consultation. These include a brief loss of consciousness, severe headache, confusion, nausea, vomiting, dizziness, or memory problems. Even if initial symptoms seem minor, a high-force impact to the face, such as from a car accident, sports injury, or assault, always warrants a medical check-up due to the potential for underlying injuries.
Professional Medical Assessment
Upon arrival at a medical facility, a healthcare provider conducts a thorough physical examination of the face. This involves visually inspecting for any asymmetry, swelling, bruising, or deformities. The practitioner will also gently palpate the facial bones to check for tenderness, irregularities, or instability that might indicate a fracture.
Assessment extends to evaluating eye movements, vision, and facial sensation, as nerve damage can manifest as numbness or tingling. Jaw movement is also assessed, along with how the teeth align, to detect any issues with chewing or speaking. Any bleeding from the nose, eyes, or mouth is also carefully noted.
To definitively diagnose a cheekbone injury and assess its extent, imaging tests are typically performed. A computed tomography (CT) scan is the preferred imaging method for facial fractures. It provides detailed, multi-dimensional images of the bone structure and surrounding soft tissues, clearly showing fractures and their displacement. While traditional X-rays may be used for isolated injuries, they are generally less accurate for complex facial fractures. Magnetic resonance imaging (MRI) is not typically used for diagnosing bone fractures.
Treatment and Recovery
Treatment for a cheekbone injury varies depending on the severity. For minor fractures where bones remain in alignment, a conservative approach is often recommended. This involves managing pain with medication, applying cold compresses to reduce swelling, and restricting activities that stress the face. Patients are advised to consume soft foods to minimize jaw movement and avoid blowing their nose for a couple of weeks to prevent air from entering tissues around the eye.
For more severe fractures, particularly those with significant displacement, surgical intervention may be necessary. Surgery aims to precisely realign the fractured bone segments and restore facial contour and function. This procedure often involves small incisions, located inside the mouth, near the hairline, or under the eyelid, to access the bone. Once realigned, bone fragments are secured with small, biocompatible metal plates and screws, stabilizing the fracture as it heals.
Following treatment, swelling and bruising are common, peaking within two to three days and gradually subsiding over two to three weeks. Complete bone healing can take approximately six to eight weeks, during which time it is important to protect the face from further impact. Numbness or tingling due to nerve involvement may take several months to improve, and sensation may not fully return. Adherence to medical instructions and follow-up appointments are important for a successful recovery.