A 6-week-old Standardbred filly presented for facial swelling due to a suspected kick to the head. Advanced imaging, including ultrasound, radiographs and computed tomography, was required to characterize the extent of the trauma and prepare for surgical fixation of the fractures using polypropylene sutures. A tailored pain-management approach was employed post-operatively using both pharmacologic and non-pharmacologic adjunctive therapies to control the filly’s pain and encourage nursing. These included non-steroidal anti-inflammatories opioids (NSAIDs), cryotherapy, and topical dimethyl sulfoxide (DMSO). Other options discussed included loco-regional anesthesia, acupuncture and therapeutic laser. Despite the risk of severe complications, the filly recovered remarkably without complications and appears to have no impairment of her functional vision at 6 week recheck. She also had an adequate cosmetic result.