When You Might Need a Plastic Surgeon in the ER

Plastic surgery isn’t just tummy tucks and facial laceration reconstruction. Plastic surgeons also play a crucial role in emergency room trauma care. 

Emergencies that Need Plastic Surgery 

Many of the injuries in the ER require multiple teams — including plastic surgeons — to care for the patient. Injuries that are often caused by direct trauma, such as a car accident, may need meticulous repair by a plastic surgeon to achieve the best aesthetic outcome upon healing. 

Some of the most common injuries that need plastic surgery involve the head, ears, eyes and nose. These include: 

• Scalp injuries caused by a blunt hit to the head, which may result in cosmetic deformity if not treated

• Nasal injuries, which can lead to respiratory and cosmetic issues without emergency plastic surgery

• Cheek lacerations, which may be repaired by a plastic surgeon to prevent nerve damage to the face

• Eyelid and/or eyebrow injuries, which can lead to vision problems down the road if not repaired properly 

Reconstruction Begins in the ER 

A trauma doctor or patient may decide to consult a plastic surgeon in the emergency room. Some common procedures plastic surgeons perform in the ER include: 

• Reattaching severed body parts

• Fixing nasal and maxillofacial fractures and breaks

• Performing facial laceration reconstruction and facial reconstruction needed after trauma

• Cleaning wounds contaminated by dirt, asphalt, glass or other debris. 

You may think of skin grafting as something a plastic surgeon does in the ER, but that surgery is more commonly done after the initial reconstructions are complete. 

A Unique Skill Set 

A plastic surgeon’s unique skill set and experience can make them the most qualified doctor to perform certain procedures in the ER. Plastic surgeons generally have a better understanding of soft tissues, the structure of the skin and how it’s all connected, allowing them to repair injuries in a meticulous and attentive manner. 

Plastic surgeons also have more experience with thinking outside the box when it comes to fixing defects, including repairing body parts or sections of skin that are missing. This type of creative problem-solving may be beyond the scope of an ER doctor. 

Follow-Up Care Is Crucial 

Follow-up care depends on the type and severity of injuries. For example, if you had plastic surgery to repair a dog bite to the face, a wound involving road debris or burn injuries, you will need consistent post-surgical care to make sure infection doesn’t develop. But in cases with a lower risk of infection, you may not need follow-up care until their wounds heal. 

What about the need for more plastic surgery to further repair damage? Experts recommend waiting at least six months before considering any revision surgery, as it takes between six months and a year for a scar to improve before healing plateaus. In other words, you want to give your body time to fully heal on its own before you consider more surgery.