Nevertheless, sources express somewhat divided opinions regarding such fixes' long-term strength.
Along with sparing Mr. Roethlisberger the nutritional consequences of a liquid diet, Dr. Pituch said, the technology typically allows a more predictable outcome that usually does not require additional major reconstructive procedures.
Before the advent of internal fixation, Gregory R. D. Evans, M.D., says, "The problem we had with all of these injuries was that, when fractured bones healed, it altered the dimensions of the face. Usually the face became a little bit longer, or potentially a little wider."
Dr. Evans is professor of surgery and biomedical engineering and chief of the Aesthetic and Plastic Surgery Institute at the University of California, Irvine.
In Mr. Roethlisberger's case, "Instead of just using the teeth to align the jaws, (surgeons) put the bones into anatomic alignment and held them there with plates and screws," says Gregory Borah, M.D., chief of plastic surgery, Robert Wood Johnson Medical School, New Brunswick, N.J. "In most cases, that's the state of the art for managing facial fractures."
Compared to the "latticework of wires" used around 15 years ago, he adds, "It's the difference between holding two pieces of wood together with a rope or using a piece of sheet metal that's nailed at either end."
The rigidity thereby achieved allows patients to perform force-generating activities such as mouth opening and closing, which help both nutritionally and in permitting aerobic exercises such as running, Dr. Borah adds.
In treating facial fractures, a patient's occupation — and risks related to it — often factor into treatment decisions, experts say.
"We want patients to be healthy, have a safe surgery and return to function as soon as possible," Dr. Borah tells Cosmetic Surgery Times.
But treating pro athletes often involves balancing their desire to return to action with the need to avoid compromising the rest of their careers, Dr. Borah explains.
Conversely, David Genecov, M.D., says, "I try not to let a patient's occupation change the surgical plan."