A torn wound
The edges are uneven, the skin and soft tissues are torn or crushed - this is what a dog bite most often looks like.
CONDITION / FACE
Consequences of animal bites on the face.
The consequences of animal bites on the face are first a wound with the risk of infection, rabies and tetanus, and later scars or tissue loss of the lip, nose, and cheek. A fresh bite is a reason to seek help on the same day; scars and defects are corrected as planned.
CONCEPTUAL VISUALIZATION- What it is
- Wounds from a dog or cat bite on the face and their late consequences - scars and tissue defects.
- Urgently
- Vaccination against rabies — on the same day: Ukraine remains endemic for dog rabies.
- Who more often
- Children: their bites most often fall on the head and neck.
- Who treats it
- Wound and vaccination — trauma center; scars and defects — a plastic surgeon.
01 / WHAT IS ITWhat is
What is
consequences of animal bites.
Most often, people are bitten by dogs, and mostly by familiar animals: their own or neighbors. On the face, the lips, cheeks and nose are most often affected. A dog usually crushes and tears tissue, while a cat leaves deeper puncture wounds.
In the first days, the main thing is infections. An animal's saliva can transmit rabies, and the face is a dangerous site for a bite, so vaccinations are started as early as possible. The risk of tetanus and wound infection with bacteria is also assessed.
Over time, the consequences remain: scars, asymmetry, loss of part of the lip, nose or ear. According to a review of studies, the most common complication after treatment of such wounds is a hypertrophic scar, that is, a thick and raised scar.
A bite can also leave a psychological mark, especially in children: fear of dogs, night terrors, anxiety.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow do they look?
How do they look?
wounds and consequences.
Immediately after the bite, it is important to assess the depth of the wound, and after months - how the skin has healed and whether there is a lack of tissue.
Stab wound
A small but deep tooth hole is a typical cat bite. From the outside, it seems small.
Signs of infection
The wound is hot, swollen, red, fluid flows from it or smells unpleasant, the temperature has risen.
Tissue loss
A part of the lip, nose or ear is torn off - restoration is required.
Defects and deformations of the lipsA rough scar
The scar is thick, red, tightens the lip or eyelid, changes the facial expression.
Scars after facial injuriesNumbness or weakness of facial expressions
Part of the face does not feel touch or moves worse - possible nerve damage.
03 / REASONSWhat do they depend on?
What do they depend on?
consequences
How well the wound heals depends on the animal, the location and depth of the bite, and how quickly treatment is started.
Time to help
In a study of 168 patients, wounds treated within 8 hours became infected in 4.5% of cases and later in 22.2%.
The size of the wound
In the same study, wounds longer than 3 cm healed with a worse external outcome, and head and neck wounds with a better one.
age
Children suffer from bites on the face more often than adults.
animal
Rabies is most often transmitted to humans by cats and dogs, and from wild animals by foxes; especially dangerous stray animals.
Vaccination
If you have not been vaccinated against tetanus for more than 10 years, after a bite you need to seek help urgently.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Any bite to the face that breaks the skin is a reason to seek medical attention the same day, even if the wound is small. Immediately wash the wound with soap and water for at least 15 minutes and apply a clean cloth if bleeding occurs. Old scars and defects are a planned situation, they do not need urgent help.
103 or immediately to the reception department, if:
- the wound is large or deep;
- the bleeding does not stop;
- part of the lip, nose or ear is torn off - wrap it in a clean tissue, put it in a bag, cover the bag with ice and take it with you.
Do not delay:
On the same day: to the trauma center or anti-rabies office after any bite, scratch or skin damage to the face — to start vaccination against rabies and check protection against tetanus; rabies vaccinations are started before any symptoms appear. On the same day - and if there may be teeth, dirt or hair in the wound, the wound is hot, swollen, oozes liquid or smells bad, has a fever or is freezing, or part of the face has stopped moving. In the coming days: to the surgeon, if the wound has already been treated, but not sewn up, and it is wide, on the lip, nose or eyelid. Planned: scars, asymmetry, tissue defects — after the scar has matured, but you can see a doctor even earlier.
05 / DIAGNOSTICSHow to evaluate
How to evaluate
injury and consequences.
- Questioning
What kind of animal, is it domestic and vaccinated, when the bite happened, what vaccinations have already been done.
- Examination of the wound
Depth, size, whether there are foreign bodies in the wound, whether there is a lack of tissue; sensitivity and facial movements are checked.
- Examination as needed
Pictures and tests are usually not needed - only if a foreign body may remain in the wound, deeper tissues are damaged or there is an infection.
- Assessment of consequences
Months later, the surgeon assesses the scars, facial symmetry, lips, nose, and eyelids and plans for recovery.
06 / TREATMENTHow we treat
How we treat
bites and consequences.
The treatment is in two stages: first, the wound and protection against infections, then, when necessary, restoration of the face shape. The first stage cannot be postponed.
01
Rabies and tetanus
The same day, outside the clinic.
- Washing
- The wound is immediately washed with soap and water for 15 minutes or longer, then treated with an antiseptic.
- Vaccination against rabies
- The course is five injections in 28 days. In case of bites on the face, head and neck, in addition to the vaccine, anti-rabies immunoglobulin is usually administered - this is decided by the doctor. The vaccine prevents the disease in 96–99% of cases; it is not possible to arbitrarily interrupt or break the course.
- Why not wait
- Once symptoms appear, rabies is almost always fatal. The latent period usually lasts 1–3 months, but can be from a week to over a year.
- Tetanus
- The doctor checks whether there is protection against tetanus and, if necessary, vaccinates.
02
Wound
The first hours and days.
- Processing
- The wound is thoroughly washed, foreign bodies and nonviable tissues are removed.
- Stitching
- On the face, bite wounds are usually sutured immediately after treatment. In a study of 600 patients with facial dog bites, infection occurred in 8.3% of unstitched wounds and 6.3% of sutured wounds—the difference was not significant, and sutured wounds healed faster.
- Antibiotics
- Whether they are needed is up to the doctor: a 2023 review advises considering prophylactic antibiotics after any bite, especially when the risk of infection is high; an older Cochrane review did not show that they reduce infection after dog and cat bites.
03
Scars and defects
In months, planned.
- Scars
- In a review of 1,384 patients, 7.8% of the operated patients had complications after surgery, most often - a hypertrophic scar. A rough scar is excised and sewn up in a new way.
- Lost tissues
- The defect is closed with a local flap - skin from a nearby area - or a skin graft.
- Psychological help
- If, after being bitten, the child is afraid of dogs, does not sleep well or is anxious, it is worth contacting a psychologist.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
A fresh bite is first treated in a trauma center or a reception department - there they also start vaccination against rabies and tetanus. Dr. Valikhnovskyi's Institute of Surgery treats the consequences of bites in the "New Face" direction: scars, tissue loss, asymmetry.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Excision of scars — a rough scar is excised and covered with local tissues.
- Perforating facial flaps — a flap of skin on a thin vessel closes the wound without rough tension and does not distort the line of the mouth or eyes.
- Flaps of adjacent zones — nasolabial, cervicofacial and frontal flaps — tissues closest in color and texture.
- Expander — for large areas: next to the defect, a supply of healthy skin is gradually "grown".
- Lipofilling — own fat evens out the contour and helps make scars softer.
- Free microsurgical flaps — if the defect is large, tissues from other parts of the body are transplanted, stitching the vessels together under a microscope.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the face directly and from the side and, if available, an extract from the trauma center.
- ConsultationExamination of scars and tissues, assessment of mimicry and sensitivity.
- PlanWhat to fix and when - usually after the scar has matured, earlier - if the scar tightens the eyelid or lip.
- SurgeryScar excision, flaps, expander or lipofilling — depending on the defect, sometimes in several stages.
- RecoveryReviews before healing; scars mature and lighten over months.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
I was bitten by a domestic vaccinated dog. Do you need a rabies vaccination?
The decision is made by the doctor of the trauma center or the anti-rabies clinic - go there the same day. Ukraine remains endemic for dog rabies, and bites to the face are dangerous.
What to do immediately after a bite?
Wash the wound with soap and water for 15 minutes or longer, treat with an antiseptic, apply a clean napkin if bleeding, and seek help the same day.
Do they sew up a bite wound on the face?
Usually yes: on the face, such wounds are often sewn up immediately after thorough treatment. The doctor decides whether it is possible to sew up your wound.
Is it necessary to drink antibiotics?
Not always, but they are often prescribed. Prophylactic antibiotics are advised to be considered after any bite, especially when the risk of infection is high; whether you need them, the doctor decides.
How many rabies shots are given?
According to modern schemes - five within 28 days. In case of facial bites, in addition to the vaccine, immunoglobulin is usually administered. It is not possible to arbitrarily interrupt the course - only the doctor can change the scheme.
When can a scar after a bite be repaired?
Usually after the scar matures, when it becomes paler and softer. Earlier — if the scar prevents closing the eye or opening the mouth.
The child was bitten by a dog, and now she is afraid of everything. Will it pass?
Fear of dogs, night terrors and anxiety are the most frequent psychological consequences of bites in children. If they persist, contact a child psychologist.
Sources
16 sources · WHO guidelines, Cochrane reviews, randomized trials, CHGs, MOH and NHSshowCollapse
- Rabies vaccines: WHO position paper, April 2018 - RecommendationsVaccine, 2018doi:10.1016/j.vaccine.2018.06.061 ↗
- Risk of rabies reintroduction into the European Union as a result of the Russo-Ukrainian war: A quantitative disease risk analysisZoonoses and Public Health, 2024doi:10.1111/zph.13135 ↗
- Rabies Reemergence, Central Europe, 2022-2024Emerging Infectious Diseases, 2026doi:10.3201/eid3202.251597 ↗
- Primary closure versus delayed or no closure for traumatic wounds due to mammalian biteCochrane Database of Systematic Reviews, 2019doi:10.1002/14651858.CD011822.pub2 ↗
- Primary closure versus non-closure of dog bite wounds. a randomised controlled trialInjury, 2014doi:10.1016/j.injury.2013.07.010 ↗
- Emergency treatment on facial laceration of dog bite wounds with immediate primary closure: a prospective randomized trial studyBMC Emergency Medicine, 2013doi:10.1186/1471-227X-13-S1-S2 ↗
- Reconstruction of face and scalp after dog bites in childrenRevista do Colégio Brasileiro de Cirurgiões, 2016doi:10.1590/0100-69912016006007 ↗
- Antibiotic prophylaxis for mammalian bitesCochrane Database of Systematic Reviews, 2001doi:10.1002/14651858.CD001738 ↗
- Dog and Cat Bites: Rapid Evidence ReviewAmerican Family Physician, 2023pubmed.ncbi.nlm.nih.gov/37983702 ↗
- Dog bite injuries to the face: A narrative review of the literatureWorld Journal of Otorhinolaryngology – Head and Neck Surgery, 2022doi:10.1016/j.wjorl.2020.11.001 ↗
- Surgical management of facial dog bite trauma: A contemporary perspective and reviewWorld Journal of Otorhinolaryngology – Head and Neck Surgery, 2023doi:10.1002/wjo2.75 ↗
- Management of Human and Animal BitesOral and Maxillofacial Surgery Clinics of North America, 2021doi:10.1016/j.coms.2021.04.006 ↗
- Review of psychological effects of dog bites in childrenBMJ Paediatrics Open, 2024doi:10.1136/bmjpo-2020-000922 ↗
- Rabies (fact sheet)WHO, 2026who.int/news-room/fact-sheets/detail/rabies ↗
- RabiesPublic Health Center of the Ministry of Health of Ukraine, 2026phc.org.ua/kontrol-zakhvoryuvan/inshi-infekciyni-zakhvoryuvannya/osoblivo-nebezpechni-infekcii/skaz ↗
- Animal and human bitesNHS, 2025nhs.uk/conditions/animal-and-human-bites ↗
The figures on the page are from these sources.
A scar remained
after a bite?
Send a photo of your face. The doctor will tell you what can be corrected and when it is better to do it.