Many facial fractures do not need surgical reconstruction. If needed, it often should be performed after the acute phase. A thorough planning and investigation with imaging and control of the function and the mobility of the eyes, yaws and teeth should be undertaken. Some fractures lead to troublesome bleedings and/or airway problems and have to be addressed at once. Airway problems and surgical timing should be discussed at an early stage between neurosurgeon, anaesthesiologist and facial surgeon to decide the best approach.