Facial trauma can follow sporting accidents, falls or assaults and can involve damage to the facial soft tissues or fracture of the facial bones. These injuries require the expertise of a maxillofacial surgeon to ensure optimal healing and cosmetic outcomes. If not treated properly these injuries can cause significant facial deformity.
Facial surgery covers reconstruction of facial trauma (soft tissue and bone), cheekbone augmentation (malar augmentation), virtual surgical planning, salivary gland surgery, and revision of post-traumatic deformity. Most acute trauma goes through the public hospital system; private and revision cases are managed at OMS Specialists.
CONDITIONS WE TREAT
OUR APPROACH
Both Richard and Ryan are highly experienced in the management of facial trauma reconstruction and manage large volumes of these cases within the public sector every week.
Whilst most of this trauma is managed through the Emergency Department and the public Maxillofacial Surgery department, our surgeons are able to assess cases for treatment privately.
OMS Specialists are ideally positioned to correct post-traumatic deformity and provide revision surgery if it is required. This may be necessary when facial trauma was managed non-surgically or poorly elsewhere, and includes scar revision, soft tissue re-suspension, fat grafting and revision facial fracture management.
Each procedure has a dedicated page with detail on recovery, anaesthesia, cost pathways, and surgeon assignment.
Surgical management of facial fractures and soft-tissue injuries to the cheekbone, orbit, nose and jaw, performed acutely or as delayed revision. Most acute trauma is managed through the public hospital system; revision and private referrals come to OMS Specialists.
Cheekbone augmentation (malar augmentation) reshapes the prominence of the cheekbone, either to correct asymmetry following trauma or growth abnormality, or for cosmetic reasons. The procedure can be performed using an implant, by repositioning the patient's own bone (osteotomy), or with fat grafting depending on what is appropriate for the case.
3D planning for complex facial reconstruction. CT data is processed in planning software to design osteotomies, custom surgical guides and patient-specific plates before surgery, which improves the accuracy and predictability of the result.
Surgical management of conditions affecting the parotid and submandibular glands, including stone removal, ductal surgery, and excision of the gland for tumour or recurrent infection.
Each surgeon carries dual qualifications (BDS + MBChB or MBBS) plus Fellowship from the Royal Australasian or English College.
Specialist Oral & Maxillofacial Surgeon
Specialist Oral & Maxillofacial Surgeon
Specialist Oral & Maxillofacial Surgeon
RECOVERY TIMELINE
Recovery varies considerably by procedure. Simple soft-tissue revision usually recovers in 1 to 2 weeks, whereas complex fracture reconstruction and salivary surgery take longer to settle.
0–1 week
Significant swelling and bruising, peaking around day 2 to 3 before settling. Soft diet, sleeping with the head elevated, and where orbital or sinus work has been performed, nose-blowing is avoided.
Vision changes, difficulty breathing, persistent vomiting, or fever over 38.5°C. Contact us immediately or attend ED.
8–21 days
Swelling continues to reduce, and a return to desk-based work is usually possible. Contact sport and heavy lifting are still avoided.
4–6 weeks
Most patients return to normal activity. Numbness around surgical sites continues to recover and bone fractures consolidate.
3+ months
Bone healing is usually complete. Soft-tissue oedema continues to resolve over 6 to 12 months. The final outcome is reviewed and revision can be considered where required.
| Phase | Duration | What to expect | Red flags |
|---|---|---|---|
| Day 1–7 | 0–1 week | Significant swelling and bruising, peaking around day 2 to 3 before settling. Soft diet, sleeping with the head elevated, and where orbital or sinus work has been performed, nose-blowing is avoided. | Vision changes, difficulty breathing, persistent vomiting, or fever over 38.5°C. Contact us immediately or attend ED. |
| Week 2–3 | 8–21 days | Swelling continues to reduce, and a return to desk-based work is usually possible. Contact sport and heavy lifting are still avoided. | |
| Week 4–6 | 4–6 weeks | Most patients return to normal activity. Numbness around surgical sites continues to recover and bone fractures consolidate. | |
| Month 3+ | 3+ months | Bone healing is usually complete. Soft-tissue oedema continues to resolve over 6 to 12 months. The final outcome is reviewed and revision can be considered where required. |
FREQUENTLY ASKED
Common questions patients ask before booking facial surgery in New Zealand.
Costs depend significantly on the complexity of the surgery, hospital theatre time, the length of any inpatient stay, and specialist anaesthetist time. Elective and revision cases vary widely. As an indication, cheekbone augmentation (malar augmentation) typically ranges NZ$8,000 to $15,000, salivary gland surgery NZ$10,000 to $20,000 including hospital, and complex post- traumatic revision is quoted on a case-by-case basis. Virtual Surgical Planning (VSP), where used, is included in the surgical estimate. At your consultation a full written estimate will be provided covering surgeon, anaesthetist, hospital and follow up.
You can make a self-referral for a non-urgent facial surgery consultation, and a GP or dentist referral is not required to make an appointment. Acute facial trauma (such as a fracture, significant laceration, or dental injury from an accident) should be assessed through the Emergency Department first, where the public Maxillofacial Surgery team will see you on-call. For revision of older injuries, post-traumatic deformity and elective cases, referrals from GPs, dentists, dermatologists and other specialists are welcomed, and help our surgeons prepare with relevant imaging (CT, OPG, or clinical photographs) ahead of your appointment.
Facial surgery, particularly fracture management, salivary gland surgery, and complex reconstruction (including post-Mohs reconstruction and post-traumatic revision) sits within the specialist oral and maxillofacial surgeon scope. The surgery itself requires dual qualification in dentistry and medicine, and is delivered in a hospital theatre with a specialist anaesthetist. Both Mr Richard Cobb and Mr Ryan Smit are highly experienced in facial trauma reconstruction and manage large volumes of these cases within the public sector every week at Auckland City Hospital and Middlemore. GPs and dentists usually triage and refer for assessment, and we will write back to your referring clinician with the plan.
Most facial fracture reconstruction, complex salivary gland surgery and major facial reconstruction is performed under general anaesthesia (complete anaesthesia) at an affiliated Auckland hospital, with a specialist anaesthetist, and may be delivered as a day-stay or with a 1 to 2 night admission depending on the case. Smaller revision and soft-tissue work, such as scar revision following facial injury or limited local-flap repair, may be performed under intravenous sedation (twilight anaesthesia) or local anaesthesia in our purpose designed surgical procedure rooms. The anaesthetic plan, fasting and recovery arrangements are confirmed at your pre-operative review.
Simple soft-tissue revisions usually recover in 1 to 2 weeks. Fracture reconstruction typically requires 3 to 6 weeks off work depending on your role and the bones involved, and salivary gland surgery is usually 2 to 3 weeks. Facial swelling and bruising peak around day 2 to 3 before settling, a soft diet is generally advised for the first week or two, and where orbital or sinus work has been performed nose- blowing is avoided. Contact sport and heavy lifting are avoided for at least 6 weeks following any bone surgery, while soft-tissue oedema can continue to resolve over 6 to 12 months. A specific recovery plan, post-operative instructions and a medical certificate will be provided.
For acute facial trauma (such as suspected facial fractures, significant lacerations, dental injury from an accident, or any concern about airway, vision or significant bleeding) please attend the Emergency Department first. The public Maxillofacial Surgery team will assess you on-call and coordinate any imaging required. Call OMS Specialists directly when the trauma is older and you were seen elsewhere and now need revision, when you are unsure whether further surgery is required, or for non-urgent assessment of post-traumatic deformity, scar revision, or soft tissue re-suspension following a previous facial injury.
Yes. OMS Specialists uses 3D Virtual Surgical Planning (VSP) for complex corrective jaw surgery (orthognathic), facial reconstruction and trauma revision cases. CT data is processed in planning software, the osteotomies are designed digitally, and custom surgical guides and patient-specific plates are produced before theatre, so the surgery is effectively rehearsed virtually first. This usually requires a 1 to 2 week lead time between planning and surgery. Used in appropriately selected cases, VSP improves the accuracy and predictability of the result and reduces theatre time. At your consultation we will discuss whether VSP is indicated for your case.
DIRECT
Online form. Our admin team will respond within one working day. For acute trauma, please attend ED first.
Request appointmentCLINICIANS
For GPs, dentists and specialists. Secure referral portal with imaging upload.
Refer a patientSPEAK DIRECTLY
Mon to Fri, 8:00am to 5:00pm. Reception will route your call to the right person.
Call (09) 477 0058