Surgical Care of Submental Gunshot Wounds

The care of patients with self-inflicted facial gunshot wounds is complex and challenging. The magnitude and self-inflicted nature of the injuries naturally give rise to questions about potential for successful rehabilitation. The surgical care and rehabilitation of ten such patients are described. The initial grotesque disfiguration belies the reasonable chances for functional restoration. Patients in this series who completed reconstruction swallow well enough to maintain body weight, speak understandably, breathe without tracheostomy, and have an appearance sufficiently normal that they can interact socially without embarrassment. Guidelines are proposed for multidisciplinary medical care leading to satisfactory functional, aesthetic, social, and psychiatric rehabilitation.