With the use of seatbelt restraints, airbags, and protective equipment such as helmets, we have seen a significant reduction in the number of multiple trauma incidents and facial fractures associated with traumatic brain injury. High speed automobile accidents and multiple trauma incidents such as plane or train crashes often bring in much more complicated cases, especially to our regional trauma centers. (J Oral Maxillofac Surg 65:1693-1699, 2007).

Very often we are considering care with multiple specialties, usually directed by an intensivist or general surgery team. Even with injuries that seem to be confined to the face it is a collaboration with general medical, anesthesia, and surgeon that leads to the best decision process for care.

For the most part, facial injuries can be initially stabilized and definitive treatment can be delayed, even for several weeks to allow for proper stabilization of general medical, cardiopulmonary, and neurological problems as they are prioritized. We can perform excellent repairs and treatments in a proper, sequential manner, in the best interests of a patient’s overall health needs. In many cases the best treatment is methodical and not rushed. Even though it looks grim at the time, I have seen many wonderful and successful outcomes with cooperative, collaborative care.