Facial Bone Contouring Surgery

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Facial bone contouring surgery is a type of surgery that involves a dissection of facial bones where there are a lot of facial nerves and blood vessels. As such, it must only be performed by a specialized surgeon.

Concerning the fact that the overall facial structure will change, this type of surgery requires thorough and systematic planning. Moreover, it is also significant to take into consideration the appropriateness with other facial features after the structure of the face has been changed.

1. Square Jaw

V-line jaw surgery is a type of surgery that is performed to correct U-line jaw and reduce the size of the chin to become smaller and V-shaped. The mandibular angles of both sides of jaw are removed and the tip of the chin is contoured into a V shape. Once the mandibular angles of the jaws disappear and the chin becomes a V shape, the overall facial structure will change significantly. When looking from the front view, the results of the surgery will be considerably satisfactory. In the event of an asymmetric face, a combination of V-line jaw surgery and asymmetry correction surgery will dramatically enhance the overall facial structure. If the squared face is due to a large and short chin, the obtained results will be even more noticeable. In the event that the basic jaw surgery does not deliver satisfactory results since the chin is still large and short, this new corrective technique will certainly increase the patients’ satisfaction.

V-Line Jaw Surgery

Enhance the results of basic jaw surgery

In addition to correcting the appearance of square jaws, this type of surgery also reduces the size of the chin to obtain a V shape. As a result, the facial structure will change significantly, especially when looking from the front view wherein the results will be more noticeable than those of the basic jaw surgery. If the patient has a square jaw due to a wide and blunt chin, the results will be even more apparent.

Emphasize on safety

V-line jaw surgery is a type of surgery that involves the dissection of facial bones where there are a lot of nerves and blood vessels. Hence, it must only be performed by a specialized and experienced surgeon. Since it is a considerably complicated surgery, it entails a thorough analysis of the facial structure through the use of a 3D CT scan in order to prevent potential effects to the nerves.

Correct the results of basic jaw surgery

If the patient is unsatisfied with the results of the basic jaw surgery, this type of surgery is the ideal solution to correct such results. In addition, it can also correct the asymmetric face.

Who is Suitable for V-Line Jaw Surgery?

Individuals who had underwent a basic jaw surgery but the face is still not a V-line.
Individuals with a large and blunt chin.
Individuals with a round face and large jaws.
Individuals with large jaws and asymmetric face.

Square Jaw Surgery

Square jaw refers to a large and angular mandible, which causes the face to appear squared. Particularly, the masseter below the ears will cause the face to appear larger than it actually is. In this case, it is ideal to remove the mandibular angles and reduce the size of the jaw, which will consequently slim down the face. For the best results, the size of the jaw should be reduced and the outermost layer of the jaw should be removed concomitantly. Jaw reduction surgery is the removal of the mandibular angles in order to create a slim face. Meanwhile, the removal of the outermost layer of the jaw refers to removing one layer out of three layers of the bone structure in order to make the jawbone appear smaller.

Jaw Contouring

If the jaw is wide, contouring the jaw and the tip of the chin is one method of a basic jaw reduction surgery. Despite some limitations, this type of surgery can deliver satisfactory results, not only for the side view but also the front view of the face. The contouring of jaw that is connected to the cheekbone, along with the contouring of tip of the chin, must contemplate the balance with the ears, eyes, nose, and overall facial structure in order to enhance the appearance of the face for both the front and side views. In the event of an asymmetric face, this problem can be solved together with this type of surgery.

Masseter Muscle Reduction Surgery

The main cause of a square face is not the jawbone but the masseter muscles. These muscles can be removed using a high-frequency energy or a Botox injection. Nonetheless, for a more permanent and noticeable result, the masseter muscle reduction surgery with a high-frequency energy is recommended.

Masseter muscle is one of the several muscles that are responsible for attaching to the mandible. It is located under the cheekbone and is the muscle that protrudes when chewing. If the growth of masseter muscles is impeded, the jaw will become smaller.

Techniques of Masseter Muscle Reduction Surgery

2. Cheekbone

3D Cheekbone Reduction Surgery

The basic theory of cheekbone reduction is excising the protruded cheekbone and moving it inwards. This technique delivers effective results for western people with a laterally protruded cheekbone. However, if the cheekbone is not excessively large, there might be a limitation in terms of moving the bone internally. Hence, a 3D cheekbone reduction serves as an alternative method that delivers satisfactory results.

3D cheekbone reduction surgery does not simply move the cheekbone internally. Rather, it will rotate the cheekbone inwards, which reduces the appearance of a laterally protruded cheekbone as deemed necessary. This technique is specifically suitable for individuals with a medium or small cheekbone and delivers results that appear more natural than the ordinary cheekbone reduction surgery. Accordingly, patients are more satisfied with the results. The overall face appears smaller and dimensional. The excised bones are perfectly healed and the recovery period is shorter.

3D cheekbone reduction surgery is performed by rotating the cheekbone inwards. The protruded portion of the cheekbone will be rotated towards the front, which will subsequently correct the problems of a flat face, add dimension to the face, and make the face appear slimmer.

Cheekbone Reduction Surgery

If the cheekbone is protruded frontally, the anterior portion of the cheekbone can be grinded through an intra-oral incision. In addition to the anterior portion of the cheekbone, the protruded posterior portion of the cheekbone can also be removed through a one-centimeter incision at the hairline above the temple and a four-centimeter incision in the oral cavity. Once these cheekbones have been excised through the foregoing incisions, the bone will be moved inwards and attached with a screw.

Cheekbone reduction surgery generally results in drooping cheeks. Hence, an additional surgery is required to prevent such problem.

Cheekbone reduction surgery will reduce the size of the bone at the center of the face. Not only will the cheekbone be reduced, but the overall face will also become smaller. Concerning the fact that this technique is different from the ordinary facial slimming technique since it still retains the portion of bone that should be protruded or indented, the overall face will not only become smaller but will also become more dimensional.

3. Jaw

Orthognathic surgery is a type of surgery that is performed to correct abnormal and problematic jaws, such as protruded chin, prominent mouth, and asymmetric face. Patients who wish to undergo jaw surgery will generally have concurrent problems relating to the teeth, such as abnormal occlusion, chewing, and speaking, whereby such problems occur as a result of the abnormality of jaw joints and occlusion. Nonetheless, jaw surgery delivers a highly satisfactory result in terms of enhancing the aesthetic appearance of the face shape, since having a small face and a V-shaped chin like those of celebrities is the big trend in this modern generation –so much that it is commonly referred to as “celebrity surgery”. Orthognathic surgery is performed with an intra-oral incision and can be divided into two techniques as follows:

1. SSRO is the most common technique since it is safe and reduces the need for physical therapy and intermaxillary fixation

Advantages of Orthognathic Surgery with SSRO

The excised bone has a wide surface, which can be easily welded.
Since the jawbones are attached, the period of intermaxillary fixation is short.
Fast recovery time for the mandible.
Specifically use to correct short chin.
Able to determine the shape of the jaw in advance.

Disadvantages of Orthognathic Surgery with SSRO

The jaw must be fixed, which may cause a lot of burden on the jaw joint.
Since the mandibular must be excised, which contains a lot of nerves, this technique may damage those nerves.
The duration of surgery is longer than the IVRO technique.
The duration of recovery is longer than the IVRO technique.

2. IVRO is the technique that corrects protruded chin without causing a burden on the jaw joint. It is suitable for individuals with jaw joint problems.

Advantages of Orthognathic Surgery with IVRO

Does not require jaw fixation, so patients can open their mouth normally after the surgery. Likewise, this technique does not cause burden on the jaw joint, while preventing injuries or pain to the joint.
The site of osteotomy does not contain nerves. Hence, this technique does not cause damage to the nerves.
The duration of the surgery is shorter than the SSRO technique.
The duration of the recovery is shorter than the SSRO technique.
Initially, this technique may require physical therapy in order to prevent the burden on the jaw joint. Hence, the mandible will be recovered faster than the SSRO technique.
The jaw surgery plate is not visible on an X-ray image.

Disadvantages of Orthognathic Surgery with IVRO

Since the jaw is not fixed, patients are required to close their mouths for two weeks in order for the mandible to be fully recovered.
During the initial period, the connected line between the jaws is discernible.
Not suitable for correcting short chin.

Indications for Orthognathic Surgery

Long face: long face may be caused by a long chin and will generally have other concurrent problems, such as a prominent mouth or protruded chin. These problems can be corrected with orthognathic surgery, which reduces the length of jaw and corrects its size to be appropriate with the maxilla. The length of the face will be reduced by half.
Protruded chin: occurs as a result of the mandibular protrusion. Protruded chin can be categorized according to the length of the face, including normal protruded chin, long face and protruded chin, and short face and protruded chin. The causes of protruded chin include excessive growth of the mandible or lack of growth of the maxilla, or both.
Short chin: has dental problems and maxillary protrusion. Short chin is generally caused by an abnormally small mandible, which results in prominent mouth and occlusional problems.
Asymmetric face: if the mandible is asymmetric, the face will become asymmetric correspondingly. A corrective surgery can be performed only when the jaw is fully developed. Asymmetric face may be solely caused by mandibular asymmetry or with a combined maxillary asymmetry.
Prominent mouth: if the mouth cannot be fully closed or the nose is positioned lower than normal (although the nose bridge is high) and there are deep nasolabial folds, this problem is referred to as prominent mouth. When placing a ruler flat against the nasal tip and the chin, the ruler will also touch the upper lip.

Orthognathic Surgery without Intermaxillary Fixation

A basic orthognathic surgery requires intermaxillary fixation, which is a method of applying tooth-mounted devices between the maxilla and mandible for a certain period of time (2-4 weeks) after the surgery in order for the jawbones to be welded. Without intermaxillary fixation, it could result in abnormal occlusion or cause burden on the jaw joint.

Orthognathic surgery without intermaxillary fixation is an alternative technique to the basic orthognathic surgery. However, this technique does not require dental fixation or application of a tooth-mounted device. Hence, this type of surgery requires a more thorough procedure and must be performed by a specialized and experienced surgeon. Within one month after the surgery, new muscles will be formed; and within six months, the bones will be fully welded. Therefore, the results are clearly noticeable.

The advantages of orthognathic surgery without intermaxillary fixation are that it is comfortable and safe, since intermaxillary fixation impedes breathing and is painful. However, an orthognathic surgery without intermaxillary fixation enables patients to open their mouth, breathe, and talk normally. Moreover, the use of titanium plate is safe on the body and can effectively hold the jawbones together without the need to remove it in the future.

In addition, intermaxillary fixation makes it more difficult for patients to eat food and clean the oral cavity. On the contrary, an orthognathic surgery without intermaxillary fixation enables patients to eat food and clean the oral cavity more easily. Likewise, since the jaw joint is not fixed, patients will not have to train opening their mouth. The recovery period of this type of surgery is similar to cheekbone and square jaw surgeries. Patients can return to their normal daily routine significantly faster than the basic orthognathic surgery.

Self-Care after Facial Bone Contouring Surgery and Orthognathic Surgery

No eating for 1 day after the surgery. After that, eat soft food or a liquid diet for 7 days (liquid diet includes food that does not require chewing such as porridge, fruit juice, and milk).
Normal intake of food is possible after 2 weeks of surgery. However, patients are required to cut food into small pieces. Hard food can be consumed after 4 weeks.
Wear a face wrap 3-4 days after the surgery. Do not sleep on a stomach or sideways. Sleep with the head elevated using 2-3 pillows in order to relieve pain.
Gargle the mouth after each meal and thoroughly clean the oral cavity to prevent infection and inflammation.
Do not drink alcohol or smoke cigarettes for 4 weeks after the surgery to speed up the healing process.
Prevent physical impact to the face until the wound is fully recovered.

Techniques for Treating Swelling after Orthognathic Surgery

Cold compression: the face will be swollen for 3-4 days after the surgery. Cold compression should be applied at all times.

Sleeping: sleep with the head in an elevated position 3-4 days after the surgery in order to facilitate blood circulation and reduce swelling. Do not remain in a sleeping position for too long.

Eating: patients are recommended to eat red beans, corn silk tea, and pumpkin juice in order to reduce swelling and facilitate digestion. Red beans help to remove excess liquids from the body.

Reviews On Facial Bone Contouring Surgery At F Clinic

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