Facial Trauma Surgery in Beverly Hills: Restoring the Face After the Worst Has Happened
Some patients arrive at a plastic surgeon’s office by choice. They have researched, considered, and decided they want something improved. The conversation is about preferences and goals and proportions.
Some patients arrive by necessity. Not by choice. Not after careful deliberation. After violence. After a car collision. After an accident that happened faster than any human being could have anticipated, and that left the face, the most visible and most identity-defining part of the body, permanently changed.
These are the patients that facial trauma surgery exists for.
Facial trauma surgery in Beverly Hills with Dr. Daniel Golshani addresses the full spectrum of facial injuries: fractured bones of the orbit, the jaw, the cheekbones, the nasal framework, and the skull, alongside the soft tissue lacerations, avulsions, and structural disruptions that violent or accidental injury produces. The goal in every case is the same: restore the anatomy as completely as possible, protect the functions that the face serves, and give the patient back a face that represents them rather than what happened to them.
Dr. Golshani brings something additional to this work that goes beyond the operating room. He is the founder of Helping Hands of Los Angeles, a nonprofit organization dedicated to providing reconstructive facial surgery to victims of domestic violence and violent injury who would otherwise not have access to the care that restores their appearance and their sense of self. It is not a marketing commitment. It is a personal one, built on the belief that the discipline of reconstructive surgery carries an obligation to serve those who need it most.
What Facial Trauma Does to the Face
The face is not simply the most visible part of the body. It is the part that carries identity, expression, and the social signals through which we communicate with every person we encounter. When the face is injured, the consequences extend well beyond the physical damage. The patient who cannot open their jaw correctly cannot eat normally. The patient with orbital floor fracture and muscle entrapment sees double with every eye movement. The patient with a visible scar across the cheek from a violent injury carries that injury into every interaction they have for the rest of their life.
Soft tissue injuries such as lacerations on the face are repaired by suturing. Bone injuries of the maxillofacial region may require rigid fixation of a fracture. drducic
Facial trauma presents two simultaneous challenges that must be addressed together: the structural damage to the bones and tissues, and the functional consequences of that damage for vision, breathing, chewing, speaking, and expression. These are not separate problems with separate solutions. They are a single clinical picture requiring a coordinated surgical response from a surgeon who understands both dimensions with equal depth.
The Causes of Facial Trauma: Who Needs This Surgery and Why
Facial trauma does not discriminate. It arrives through motor vehicle collisions, workplace accidents, sports injuries, falls, and violence. And it arrives, more often than most people realize, through the hands of someone the patient knew and trusted.
Domestic violence is one of the leading causes of facial fractures and facial soft tissue injury in the United States. Studies consistently document that women who have experienced domestic violence suffer facial injuries at dramatically higher rates than the general population, and that the face is the most commonly targeted zone in assaults. For these patients, the injury is not only physical. It is woven into a context of trauma, fear, and the disruption of the life they had before.
This is the patient that Dr. Golshani had in mind when he founded Helping Hands of Los Angeles. Not an abstract demographic. A specific kind of person who has survived something devastating and who deserves access to the reconstructive surgery that can give them their face back, regardless of whether they have the financial resources to pay for it.
Beyond domestic violence, facial trauma surgery addresses:
Motor vehicle and motorcycle collisions, which remain the leading cause of high-energy facial fractures involving multiple bones simultaneously.
Assault and penetrating injury, including both blunt trauma and injuries from weapons or projectiles that produce complex fracture patterns and significant soft tissue disruption.
Sports and recreational injury, including contact sports, bicycle accidents, and falls from height that produce isolated or combined facial fractures.
Occupational accidents, particularly in construction, industrial, and agricultural settings where facial protection is absent or insufficient.
Falls in elderly patients, where the bones of the face are more brittle and the consequences of injury more significant than in younger patients with the same mechanism.
The Anatomy of Facial Trauma: What Gets Injured and Why It Matters
The bones of the face are not uniform in their strength or their vulnerability. They are organized around a system of structural buttresses, strong columns of bone that transmit the forces of chewing and trauma through the facial skeleton to the skull base. Between these buttresses sit thinner, weaker zones that are the first to fracture when the face absorbs force. Understanding these anatomical patterns is what allows a reconstructive surgeon to look at a facial injury, understand what broke and what held, and plan a repair that restores the structural architecture rather than simply addressing the most obvious visible damage.
Nasal Fractures
The nasal bones are the most commonly fractured bones in the face, sitting at the most prominent and least protected position. An isolated nasal fracture can often be reduced non-surgically if treated within the first seven to ten days before the swelling fully resolves and the bone begins to consolidate in its displaced position. More complex nasal fractures involving the septum, the nasal dorsum, and the cartilaginous framework require surgical reduction and in some cases open repair with fixation.
The relationship between traumatic nasal injury and subsequent nasal deformity is one that benefits from Dr. Golshani’s dual expertise in facial trauma repair and rhinoplasty. A nasal fracture that heals in an uncorrected position produces both a visible deformity and in many cases a functional breathing impairment. The Revision Rhinoplasty page addresses the surgical correction of post-traumatic nasal deformity when the acute fracture has healed in a suboptimal position.
Orbital Fractures
Orbital fractures involve the bones surrounding the eye and may affect eye position, movement, or vision. These injuries can trap soft tissue or muscles within the fracture, leading to double vision or changes in eye alignment. Treatment focuses on restoring orbital support and protecting the structures of the eye while preserving facial symmetry. drducic
The orbital floor is the thinnest and most vulnerable surface of the orbital box. A direct blow to the eye or the surrounding periorbital bone transmits hydraulic pressure through the orbital contents that fractures the floor downward, sometimes taking orbital fat and the inferior rectus muscle with it into the maxillary sinus below. The result is enophthalmos, a sunken eye position, and diplopia, double vision, from the entrapped or tethered muscle.
Large fracture size that puts patients at risk for enophthalmos and evidence of muscle entrapment are the primary indications for surgery. Orbital floor repair uses titanium mesh, porous polyethylene, bone grafts, or resorbable implant materials to reconstruct the floor and restore the correct orbital volume, releasing any entrapped tissue and correcting the eye position. The approach is typically transconjunctival, through the inner surface of the lower eyelid, where the access incision is entirely hidden. craniofacialteamtexas
Zygomaticomaxillary Complex Fractures
The zygoma, or cheekbone, is the prominence that defines the lateral face in profile. Zygomaticomaxillary complex fractures, sometimes called tripod fractures, occur when the cheekbone is displaced from its three articulations with the surrounding facial skeleton: the orbital rim, the temporal bone, and the maxilla. The result is a visibly flattened cheek, potential orbital floor disruption, infraorbital nerve injury producing cheek numbness, and in severe cases interference with the coronoid process of the mandible that limits jaw opening.
Repair requires reduction and fixation of the zygoma back to its correct position using plates and screws placed through incisions at the brow, the lower eyelid, and the mouth, where they are entirely concealed.
Mandibular Fractures
Mandible fractures affect the lower jaw and can disrupt bite alignment, speech, and chewing. Depending on the location and severity, treatment may involve rigid fixation with plates and screws or temporary stabilization of the jaw. Restoring proper occlusion and jaw function is a central goal of repair. drducic
The mandible is the only mobile bone of the face and its correct position relative to the upper jaw determines the patient’s bite, their ability to chew, and the lower facial profile. A fractured mandible that heals in a displaced position produces malocclusion that cannot be corrected without surgical refracture and repositioning. Timing matters: the best outcomes come from repair within the appropriate early window before consolidation begins.
Le Fort Fractures
Le Fort fractures are high-energy fractures that separate portions of the midface from the skull base along defined anatomical planes first described by René Le Fort following his systematic studies of cadaveric facial fracture patterns in 1901. Le Fort I fractures separate the tooth-bearing portion of the maxilla. Le Fort II fractures separate the central midface including the nose and orbital rims. Le Fort III fractures, the most severe, produce craniofacial separation, disconnecting the entire facial skeleton from the skull. These fractures are associated with high-energy trauma and frequently require combined craniofacial and neurosurgical management.
Frontal Sinus and Skull Base Fractures
Frontal sinus fractures require careful assessment due to their proximity to the brain and sinus drainage pathways. Treatment is tailored to the severity of the fracture and may involve reconstruction to protect sinus function and reduce the risk of long-term complications. drducic
The frontal sinus sits directly behind the forehead, and fractures of its anterior wall produce a visible contour depression of the forehead. Fractures involving the posterior wall of the sinus, which borders the anterior cranial fossa, carry the risk of cerebrospinal fluid leak and intracranial complication, requiring neurosurgical coordination.
Soft Tissue Lacerations and Avulsions
Complex facial lacerations, particularly those involving the vermilion border of the lip, the nasal rim, the eyelid margin, or the ear, require layered anatomical repair that restores each tissue layer in correct alignment. A vermilion border mismatch of even one millimeter is visible under normal social lighting. An eyelid margin laceration that heals with notching disrupts the smooth lid contour permanently. These repairs demand the same anatomical precision that every facial plastic surgery procedure requires, applied under the urgency of acute trauma care.
The Timing of Facial Trauma Surgery
Facial trauma surgery rarely operates in a single, simple timing window. The correct timing depends on the type of injury, the degree of swelling, the patient’s overall medical status, and what other injuries may have occurred simultaneously.
For soft tissue lacerations, repair is performed as soon as possible following the injury, ideally within the first several hours, while the wound edges are fresh and the tissue is most amenable to clean primary closure.
For facial fractures, the approach is more nuanced. Some fractures, particularly those with muscle entrapment in the orbit or acute malocclusion from mandibular displacement, require prompt surgical intervention within the first twenty-four to forty-eight hours. Others benefit from a brief delay of five to seven days to allow the acute swelling to reduce, improving the surgical visibility and making the repair more precise. And some fractures, particularly in patients with multiple injuries whose overall medical stability takes priority, may be repaired after a longer interval, with the surgical plan adapted to the anatomical changes that consolidation has begun to produce.
Helping Hands of Los Angeles: Surgery as a Social Commitment
Dr. Golshani founded Helping Hands of Los Angeles because he understood something that is easy to overlook in a private surgical practice in Beverly Hills: that the patients who need reconstructive facial surgery the most are frequently the ones with the least access to it.
A victim of domestic violence who has had her face fractured does not always have insurance coverage for the reconstruction. She may not have the financial resources to pursue care independently. She may be managing the practical and psychological consequences of an abusive situation that make navigating the healthcare system enormously difficult. And she may be carrying the visible evidence of what happened to her into every day of her life in a way that compounds the trauma she has already experienced.
Helping Hands of Los Angeles exists to change that. Through the nonprofit, Dr. Golshani provides reconstructive facial surgery to victims of domestic violence and violent injury, donating his surgical expertise to patients who cannot pay for the care they need. The work is not publicized in the way that most charitable initiatives are. It is simply done. Because the discipline of reconstructive surgery carries an obligation that goes beyond the patients who can afford it, and because the face that has been injured by violence deserves the same standard of surgical care as any face that walks through the door.
If you or someone you know is a victim of domestic violence or violent injury and needs reconstructive facial surgery, please contact Dr. Golshani’s practice directly. The conversation will be handled with complete confidentiality and without judgment.
When Facial Trauma Surgery Is Part of a Larger Reconstructive Plan
Facial trauma surgery is rarely the end of the reconstructive journey. After the acute repair has healed and the anatomy has stabilized, secondary procedures frequently address what the primary repair could not fully resolve:
- Revision Rhinoplasty for post-traumatic nasal deformity that healed in a displaced position following the original injury or was inadequately repaired initially
- Revisional and Reconstructive Facial Surgery for the broader category of secondary facial reconstruction including scar revision, contour correction, and functional repair after traumatic injury
- Eyelid Lift, Blepharoplasty and Eyelid Reconstruction for periorbital consequences of orbital trauma including eyelid malposition, ectropion, and structural disruption of the eyelid framework
- Microsurgery for complex avulsion injuries or tissue loss requiring free flap reconstruction to restore coverage and structure
- Facial Autologous Fat Grafting with G-Stem to restore soft tissue volume in areas where trauma has produced permanent soft tissue deficiency or where scar tissue has replaced native tissue bulk
- Plastic and Reconstructive Surgery as the foundational disciplinary context within which all facial trauma reconstruction sits
Why Patients Choose Dr. Golshani for Facial Trauma Surgery in Beverly Hills
Facial trauma patients need a surgeon who has the technical depth to address every layer of what the injury produced, from the fractured bone to the disrupted soft tissue to the functional consequences that affect daily life, and who understands that the person sitting across the consultation table is dealing with more than a surgical problem.
Dr. Daniel Golshani, MD, FACS is a board-certified plastic and reconstructive surgeon whose nine years of post-medical school training across two surgical residencies and two subspecialty fellowships encompass the full breadth of facial reconstructive surgery. His general surgical residency training provides the foundational surgical knowledge that complex multi-system trauma requires. His plastic surgery residency and fellowship training provide the reconstructive precision and aesthetic judgment that facial trauma repair demands at every level of complexity.
He is also a human being who decided that his surgical skills carry an obligation beyond his private practice, and who founded Helping Hands of Los Angeles to act on that belief. That combination, technical excellence and genuine purpose, defines what this practice is.
His office is located at 9301 Wilshire Blvd., Suite 410 in Beverly Hills. Surgical procedures are performed at the Rexford Surgical Institute on the same floor, or at affiliated hospital facilities for cases requiring overnight monitoring or neurosurgical coordination.
Your Facial Trauma Surgery Journey: Step-by-Step
Step 1 — Assessment and Consultation
Acute facial trauma assessment begins with a clinical examination of the full facial skeleton and soft tissue, review of CT imaging documenting the fracture pattern and extent, assessment of functional consequences including visual changes, bite alignment, and airway status, and a conversation with the patient about what happened, what the consequences have been, and what the surgical plan can achieve. For patients presenting through Helping Hands of Los Angeles, this consultation carries the same standard and the same care as every other consultation at this practice.
Step 2 — Surgical Planning and Timing
The timing of repair is determined by the injury type, the degree of swelling, the patient’s medical status, and what other injuries were sustained. Soft tissue lacerations are repaired promptly. Fractures are repaired at the correct surgical interval for that specific injury, balancing the benefit of early intervention against the visualization advantage of reduced swelling.
Step 3 — The Procedure
Facial trauma surgery is performed under general anesthesia at the Rexford Surgical Institute or at an affiliated hospital facility for complex multi-system cases. Incisions are placed in natural skin creases, within the hairline, inside the mouth, or through the conjunctiva wherever possible to minimize visible scarring. Fractures are reduced and fixed with titanium plates and screws or resorbable hardware. Soft tissue is repaired in anatomical layers. The procedure time varies from one to several hours depending on the scope of the injury.
Step 4 — Recovery and Secondary Procedures
Initial recovery from facial trauma repair involves swelling and bruising that resolves over the first two to three weeks. Most patients return to normal activity within two to four weeks. Secondary procedures for scar revision, contour refinement, or functional correction are planned after the primary repair has fully healed and the anatomy has stabilized, typically six to twelve months following the initial surgery.
Facial Trauma Surgery FAQs -Beverly Hills, CA
What is facial trauma surgery in Beverly Hills?
Facial trauma surgery is the surgical repair of injuries to the bones and soft tissues of the face following accidents, assault, or domestic violence. Dr. Daniel Golshani performs the full range of facial trauma repair in Beverly Hills, including nasal fractures, orbital floor fractures, zygomaticomaxillary complex fractures, mandibular fractures, Le Fort fractures, and complex soft tissue lacerations. He also provides reconstructive facial surgery to victims of domestic violence through his nonprofit, Helping Hands of Los Angeles.
What is Helping Hands of Los Angeles?
Helping Hands of Los Angeles is a nonprofit organization founded by Dr. Daniel Golshani to provide reconstructive facial surgery to victims of domestic violence and violent injury who cannot access or afford the care they need. It is a direct expression of Dr. Golshani’s belief that the reconstructive surgery discipline carries an obligation to serve those who need it most, regardless of their financial circumstances. Patients who need help can contact Dr. Golshani’s practice directly. All inquiries are handled with complete confidentiality.
What types of facial fractures require surgery?
Indications for surgery include orbital fractures with muscle entrapment producing double vision or eye position changes, displaced zygomaticomaxillary fractures, mandibular fractures disrupting bite alignment and jaw function, and frontal sinus fractures with displaced posterior wall involvement near the brain. Nasal fractures may be reduced non-surgically if addressed promptly, or surgically for complex patterns. Le Fort fractures of the midface require surgical reduction and fixation. The decision for each fracture depends on the degree of displacement, the functional consequences, and the timing of presentation. craniofacialteamtexas
When should facial fractures be repaired?
Timing depends on the injury type. Soft tissue lacerations are repaired as soon as possible after injury. Orbital fractures with muscle entrapment require prompt intervention. Most facial bone fractures are optimally repaired within the first seven to fourteen days, either immediately or after a brief interval to reduce swelling and improve surgical visibility. Fractures in patients with multiple injuries may be repaired later, adapted to the anatomical changes that early consolidation has produced.
What is an orbital floor fracture and how is it repaired?
An orbital floor fracture occurs when force applied to the eye or surrounding bone breaks the thin floor of the orbital cavity, sometimes pushing orbital fat or the inferior rectus muscle into the sinus below. This produces a sunken eye position and double vision from the trapped muscle. Repair restores the orbital floor using titanium mesh, porous polyethylene, or bone grafts placed through a hidden incision inside the lower eyelid, releasing the entrapped tissue and restoring the eye to its correct position.
Is facial trauma surgery covered by insurance?
Yes. Facial trauma surgery is covered by health insurance as medically necessary care following injury. For patients presenting through Helping Hands of Los Angeles who do not have insurance coverage, Dr. Golshani’s practice handles the financial dimension directly through the nonprofit framework.
What scars are produced by facial trauma surgery?
Dr. Golshani places all surgical incisions in the most concealed locations available: inside the mouth for mandibular and maxillary repair, within the lower eyelid conjunctiva for orbital floor repair, in the brow crease or hairline for forehead and frontal sinus access, and within natural skin creases wherever possible. Incisions from the original traumatic lacerations are repaired with meticulous layered closure and followed with a comprehensive scar management protocol that begins during healing and continues through scar maturation.
How much does facial trauma surgery cost in Beverly Hills?
For patients with insurance, facial trauma surgery is covered as medically necessary care. For patients presenting through Helping Hands of Los Angeles, cost is not a barrier to receiving care. For self-pay patients outside the nonprofit framework, cost varies by the scope of the injury and the procedures required. Dr. Golshani’s team provides clear, direct information during consultation.
When preparing for a facelift consultation, it’s essential to gather I nformation about your medical history, current medications, and desired outcomes. Additionally, bring along any questions and photos of your ideal to discuss with Dr. Golshani and his surgical coordinators. Additionally, its always important to be open about your expectations and concerns.
Before your facelift surgery, follow Dr. Golshani’s pre-operative instructions carefully, which will include fasting before the procedure, avoiding certain medications that can increase bleeding risk, and arranging for transportation to and from the surgical facility. It is also important to make sure that you have a comfortable recovery area at home with necessary supplies following your facelift procedure.
The improvements made with a facelift last for years. Your face will continue to age naturally, but you’ll always look younger than you would have without the surgery. You can extend the results and slow the effects of aging by maintaining a stable weight and taking good care of your skin, especially by protecting it from excessive exposure to the sun. If, after a few years, you’re bothered by the effects of aging, you might choose to have a refresher facelift. Nonsurgical treatments can also complement the improvements made with a facelift.
There is no right age for facelift surgery. Timing depends on the changes to your face over time and your readiness for surgery. The surgery is simpler and results last longer for younger patients (in their early 40s, for example) because of the elasticity and resilience of younger skin. But we have had facelift patients in their 70s and 80s who have been delighted with their results. A one-on-one consultation is the best way to determine if you are a good candidate.
Only a surgical facelift can make the comprehensive and long-lasting enhancements to an aging face you see in the before and after pictures on this site. That’s not to say that everyone who’s bothered by the signs of aging needs a facelift. Positive improvements can be made with non-surgical and minimally invasive treatment. Options include chemical peels, microdermabrasion, laser skin resurfacing, dermal fillers, Botox®, and endoscopic procedures. We can combine a customized series of non-surgical treatments to give you a personalized minimally invasive facelift.
The duration of a facelift procedure can vary depending on the extent of the surgery and the particular techniques used by Dr. Golshani. On average, a traditional facelift may take several hours, while a mini-facelift may have shorter operating times.
Typically, a traditional facelift is a more comprehensive procedure that addresses sagging skin, muscle laxity, and excess fat in the face and neck area. In contrast, a mini-facelift, also known as a limited incision facelift, focuses on targeting specific signs of aging in a more limited area with a shorter recovery time and less dramatic results.
A non-surgical facelift typically involves minimally invasive treatments like injectables, laser therapy, or skin tightening procedures to improve facial contours and reduce signs of aging without surgery. In comparison, a traditional facelift is a surgical procedure that involves lifting and repositioning facial tissues for more significant and long-lasting results.
To prolong facelift results, maintain a healthy lifestyle with a balanced diet, regular exercise, and proper skincare routine. Protect your skin from sun exposure, avoid smoking, and follow Dr. Golshani’s post-operative instructions for optimal healing and long-term outcomes.
Swelling, bruising, and initial healing after a facelift may vary, but most of our patients feel comfortable going out in public within 1-2 weeks after surgery. Additionally, makeup can help conceal any residual bruising or redness during the early stages of recovery.
Strenuous exercise and activities should be avoided for several weeks after a facelift to allow for proper healing and minimize the risk of complications. Dr. Golshani and his surgical team will provide guidelines on when you can gradually resume physical activities based on your individual recovery progress.
Generally speaking, the timing of returning to work after a facelift depends on the extent of the surgery, individual healing process, and the nature of your job. Most patients can expect to return to work within 1-2 weeks, but it may vary for each person.
Smoking can have detrimental effects on the healing process and outcomes of a facelift. It is advisable to quit smoking before undergoing a facelift to reduce the risk of complications, improve circulation, and promote optimal wound healing. If you are a smoker, being transparent with Dr. Golshani is incredibly important so that, together, you can come up with the best course of action prior to your facelilft surgery.
A deep plane facelift is a surgical technique that involves lifting and repositioning deeper facial tissues, specifically the SMAS (superficial musculoaponeurotic system). This technique can provide more significant and longer-lasting results compared to a traditional facelift by addressing sagging tissues in a more comprehensive manner. Dr. Golshani is incredibly skilled and experienced with performing deep plan facelifts and uses this technique very often.
On the other hand, a hybrid facelift combines surgical and non-surgical techniques to address facial rejuvenation tailored to each patient. This approach may involve a combination of facelift surgery with injectables, laser treatments, or other minimally invasive procedures to enhance facial contours and address multiple signs of aging. Consulting with a board-certified plastic surgeon, such as Dr. Golshani, can help you determine the most suitable facelift approach based on your goals and anatomy.
