A grim—looking Prime Minister Silvio Berlusconi waved weakly to photographers on Thursday as he left a Milan hospital with his face covered in bandages four days after an attack by a mentally ill man at a political rally.

A large bandage covered part of the left side of Mr. Berlusconi’s face including his nose, which was broken when the man hurled a souvenir statue of Milan’s cathedral into the premier’s face.

Mr. Berlusconi, 73, broke two teeth in the attack and another bandage was placed between the nose and the lip.

He took a few steps out of the San Raffaele Hospital before getting into one of several cars in a waiting motorcade.

News reports said the motorcade was headed to Arcore, the media mogul’s villa on the outskirts of Milan. An official in his office declined to comment on the destination.

The attacker, identified as Massimo Tartaglia, is under arrest in a Milan prison.

Mr. Berlusconi said in a statement released by his office that he would go on “with more strength and determination than before.”

“I will remember two things about these days: the hatred of a few and the love of many, many Italians,” the statement said.

Mr. Berlusconi, who is fending off a sex scandal and legal troubles, had previously lamented that he was the target of a “climate of hatred.” His injuries stirred public sympathy but groups praising Tartaglia mushroomed on Facebook after the attack.

On Wednesday, a judge rejected a bid by Tartaglia’s lawyers to have him transferred from jail to a psychiatric hospital.

Known for his seemingly boundless energy, Mr. Berlusconi was ordered by his doctors to cancel or reduce public appearances through the Christmas season.

A Cabinet meeting in Rome was held without the premier’s presence. Mr. Berlusconi was also skipping the last days of the climate change conference in Copenhagen.

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