The facial skeleton is a collective of bones in the skull that comprise the underpinnings of the structures of the face. Some important bones in the facial skeleton include the nasal, mandible, maxilla, and palatine bones. Disorders of this part of the skull can vary in nature from cosmetic conditions to serious congenital birth defects that impair functions of the face like eating and smelling. Specialists like maxillofacial surgeons focus on the structure of the facial skeleton to better serve their patients.
In total, the facial skeleton includes two maxillae; two zygomatic bones; two nasal bones; two palatine bones; two lacrimal bones; two inferior nasal conchae; one mandible; and one vomer bone. Most of these bones are paired to provide symmetrical support to the face, while some lie on the midline and do not need to be duplicated. The bones of the face do not, for the most part, articulate like other bones in the body. They are not jointed and do not need to flex and bend with stress, with the exception of the jawbone, which articulates for eating, breathing, and speaking tasks.
At birth, the facial skeleton is joined with a series of soft cartilaginous connections. These provide room for the skull to grow as people mature, and harden with time to create less tenuous bonds and add stability to the skull. One important function of these bones, as with the rest of the skull, is protection of the brain as well as structures like the eyes and tongue. It also creates attachment points for facial muscles, tendons, and nerves.
Injuries to the facial skeleton can cause a variety of medical problems. On a low level, fractures and other injuries may change the appearance of the face, which could lead to distress. Higher level injuries could interfere with vision, sense of smell, and other senses. In some cases, the brain could even be exposed with a serious facial injury, which could lead to severe complications, including brain damage. Surgery may be necessary to repair the damage.
Some congenital conditions are associated with anomalies in the facial skeleton. These occur as errors during development caused by the same chromosomal abnormalities that cause the underlying condition. Facial structures may fail to completely develop, or could be crowded on the face. Surgery can help patients with such conditions. Plastic surgery specialists can perform an evaluation to determine what kind of surgery would be beneficial and make a surgery plan to modify the facial structure.