Mandibular  Contouring

Mandibular Contouring

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What is mandibular contouring?

Mandibular contouring is a surgical procedure intended to create a smaller, smoother and sloping mandibular angle that is in harmony with the facial features.

Why is mandibular contouring considered by some individuals?

Overly prominent cheekbones and distinct lower jaw angle is considered unattractive specially for those who have subtle facial features like most Asians. It upsets the balance, makes the face overly flat, wide and square.

Can a BOTOX treatment to contour the mandibles provide the same result as the surgical approach?

For mild to moderate forms of mandibular angles, BOTOX provides temporary significant improvement by reducing the muscle thickness despite the remaining boney prominence. The duration of the effect is still under study. However, surgery is preferred for more severe cases and for those who want permanent result.

What are the benefits of mandibular contouring?

– Creates a smoother mandibular angle resulting to a more balance facial features
– Makes wide face smaller
– Reduces overly prominent cheekbones

How long is the procedure?

Mandibular contouring is an outpatient procedure which takes approximately 3 to 4 hours.

How is the procedure done?

Small incisions are made inside the mouth, just between the gum and cheek mucosa, to access the prominent areas of jaw bone. With the use of template model from x-ray film, the line of bone resection is determined. The marked areas are cut, curving down from back to front. In case of cheekbone reduction, another tiny incision is created just before the ear to bur and in-fracture the zygomatic arch.

Will there be any visible scar?

Mini-incision will be nearly invisible once the healing is completed. All stitches are self-dissolving.

What kind of anesthesia is used?

This procedure is done under general anesthesia.

Who are the candidates for this procedure?

Good candidates for this procedure are those who are generally healthy, emotionally and psychologically stable, with realistic expectations, and want to correct the following facial concerns:
– Very high cheekbones
– Overly prominent lower jaw
– Wide, flat and square face

Candiaites are advised to disclose their medical history, illness and medications during the consultation.

How is the pre-operative assessment done?

Dr. Lansangan determines the amount and line of bone resection through clinical examination and x-ray reviews of the patient. The amount of the muscle is estimated by physical examination. The evaluation, risks, limitations of the procedures and the possible projected surgical outcome are discussed to the patient. The patient shall likewise be required to undergo order routine laboratory studies including a CBC count and other studies such as coagulation profiles and ECGs.

What is recovery like?

There will be swelling and mild to moderate pain. Temporary numbness may be experienced along the incision line or around the lower lip. For mandibular contouring, exercises to stretch the muscle begin on the first week. Mouth opening exercises are done for the first 2 to 3 weeks. Diet is phased as follows: day 1 – clear diet; 1 week after – liquid diet; 2 weeks after – soft diet. In case of cheekbone (zygoma) reduction, compressive dressings and drains are removed a day after the surgery. Starting on the 3rd day, every other staple is removed. A soft diet guide which shall be taken based on the patient’s tolerance is given. A special oral hygiene has to be observed to clean the mouth.

How soon can a patient go back to work?

Much of the swelling is resolved in about 10 days making it possible for the possible to go back to work. However, for those with strenuous job, it may take 3 to 4 weeks.

How soon can results be seen?

Significant improvement can be seen right away when majority of the swelling and bruising is gone by the 2nd week. The final result will be evident at 3 to 6 months when all the swelling has resolved.

What are the possible complications?

Complications occasionally happen but can be avoided. Risks include bleeding and prolonged swelling, asymmetry, nerve injury and infection. Bleeding and prolonged swelling can be prevented with the use of surgical drains and facial pressure garment. Asymmetry or over-resection can be avoided with a careful pre-operative assessment, x-ray templates and a set of fine surgical instruments reduces this risk except when there is already an existing asymmetry prior to the procedure. This pre-operative asymmetry is pointed out to the patient before the surgery.

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