Management of Avulsive Soft Tissue Ballistic Facial Injuries

Ballistic facial injuries, though rare, present significant challenges for plastic surgeons due to avulsive tissue loss and require careful assessment and staged reconstruction. The reconstruction process varies by facial region and can range from primary closure to multistage free flaps. Advances in composite tissue transplant and allografts have improved the ability to reconstruct large facial defects. This review emphasizes the importance of fundamental soft tissue management and reconstruction techniques to achieve optimal aesthetic and functional outcomes for patients with severe facial ballistic injuries.