Jawline sculpting, chin implants and orthognathic surgery

Who can benefit from jawline sculpting, chin implants and orthognathic surgery?

If you're thinking of orthognathic surgery, chin implants or jawline sculpting it is important to know that orthognathic surgery is the ideal solution if your facial and jaw bones are misaligned requiring change to the underlying bone structure. Alternatively, one can sculpt the jaw with either dermal jawline fillers or jawline and chin implants. 

For orthognathic surgery, the surgical interventions are offered to patients who meet the criteria and are willing to undergo a comprehensive treatment plan, including pre and post-operative orthodontic procedures, which typically span 2-3 years.

Fillers - For this procedure, allow an hour in the clinic but the results are instantaneous with minimal downtime. Jawline sculpting can soften certain features or create a more chiselled profile. Chin sculpting is typically a maximum of 2ml initially, sometimes planning to inject an extra 1 - 2 ml after a week. Jawlines an are more varied, strengthening and defining the jawline can dictate 2 - 3 ml each side.

Chin and jawline implants - The operative time, costs and downtime are a little greater, but instead of lasting 1-2 years like fillers and jaw sculpting the implants will last a lifetime for most patients.

Orthognathic surgery - A period of pre surgical orthodontics would be required for around 18 months followed by an operation under general anaesthetic as a Le Fort 1 level midface osteotomy and/or a bilateral sagittal split osteotomy of the mandible. 

This requires an overnight stay in hospital and a period of 6 weeks soft diet afterwards, as well as a further period of post operative orthodontics for a further 6 to 12 months.

The risks associated with the operation include bleeding and infection that are minimised by ensuring a relaxed post operative period, avoiding any strenuous exercise and maintaining good hygiene of the surgical wounds and good oral hygiene of the orthodontic appliances. 

Further risks discussed include those associated with an unfavourable split of the bone that may dictate additional surgical osteosynthesis fixation via a small incision in the cheek, a period of intermaxillary fixation whereby the jaws are wired together, and rarely the utilisation of bone grafts from the hip. 

Sensory nerves need to be osteotomised out of the way and the resultant numbness, tingles or pins and needles that can ensue thereafter that can also result in painful areas or electric shock like feelings as the nerve heals, over an 18 month period. 

The removal of fixation plates and screws may be required in the months or years after the osteotomy, as a small general anaesthetic operation in the future. 

Details of the journey for orthognathic surgery

Prior to your operation, several essential steps need to be completed to ensure a successful outcome:

Orthodontic Treatment - Under the care of our expert orthodontists, you will receive customized treatment to prepare your teeth for the upcoming surgical intervention. This may involve wearing braces for an extended period, usually around 18 months before surgery and six months after, until your teeth have achieved optimal alignment and stability. Following the orthodontic phase, a removable retainer brace will be provided to maintain your teeth in their new position during the healing process.

Planning Appointment - Once your pre-surgery orthodontic treatment is complete, you will be invited to a detailed planning appointment at our esteemed orthognathic clinic. This comprehensive session, held at our Cheshire or Shropshire centers, involves a range of assessments and evaluations, including:

- Medical Photography: Capturing precise images to aid in the planning process.

- X-rays: Utilizing advanced imaging techniques such as Cone Beam Computed Tomography (CBCT) and lateral cephalogram to obtain detailed 3D images of your teeth and facial structures.

- Speech Assessment: Our dedicated speech and language therapists will assess any potential impact on your palate function and speech following the surgery. Rest assured that most patients experience minimal speech-related issues, and suitable treatment options are available for those requiring additional support.

- Psychological Assessment: Meeting with our compassionate clinical psychologists to ensure you have a thorough understanding of the procedure and to discuss your expectations, ensuring a positive surgical experience.

- Impressions (Moulds): Our skilled orthodontists will take precise impressions of your teeth, which will serve as the basis for creating custom-made plastic wafers. These wafers aid the surgeon during the operation, ensuring precise positioning and alignment.

- Surgeon's Appointment: An invaluable consultation with our experienced surgeons who will thoroughly explain the intricate details of the proposed operation, addressing any questions or concerns you may have.

While certain assessments may require separate appointments for optimal accuracy, we strive to streamline the process to minimize inconvenience for our patients.

Pre-operative Assessment - Before your surgery, a crucial pre-operative assessment will be conducted, during which we perform comprehensive checks and verify the suitability of the custom-made wafers. This appointment, led by our skilled surgeons and taking place within our oral surgery department, serves as the final step before your operation. Attendance is of utmost importance, as any delay may impact your scheduled surgery.

The Operation: Transformative and Scarless  - Rest assured that our jaw surgeries are performed internally, ensuring no visible scarring. In rare cases, minimal incisions may be made on the bridge of the nose or under the jawline, which become virtually invisible within a few weeks post-surgery.

Double Jaw Surgery (Bimaxillary Osteotomy) - To correct facial harmony as well as addressing the bite and alignment of the teeth, precise cuts are made on the upper and lower jaws, taking care to avoid any damage to the teeth and nerves in the lips, gums, and roof of the mouth. The repositioning of the jaws is then performed, and small titanium plates and screws are utilized to secure the bones in their new position. These implants are typically left in place permanently, allowing the bones to heal and maintain the correct alignment.

Lower Jaw Surgery (Mandibular Osteotomy) - For patients requiring improvement in bite and chin position, a precise cut is made on the lower jaw, ensuring the preservation of teeth and nerves in the lower lip. The lower jaw is then repositioned to achieve the desired outcome.

Potential Risks and Side Effects

While complications are rare, it's important to be aware of potential risks associated with any surgical procedure. The following are some considerations to discuss with your surgeon:

1. Bleeding: Minor oozing is normal immediately after the surgery, but significant bleeding is uncommon. In the event of heavy bleeding, applying pressure to the area with a rolled-up handkerchief or swab for at least 10 minutes usually stops it.

2. Numbness: It's common to experience numbness and tingling in the lower lip after the operation, similar to the sensation following a dental injection. This numbness typically subsides over a few months, but in rare cases, it may be permanent. Disaesthesia, characterized by an uncomfortable or burning sensation, can also occur.

3. Infection: The small plates and screws used to stabilize the jaw bones are generally left in place permanently. While infection is uncommon, it can occur months after the surgery, necessitating their removal.

4. Adjustment of the Bite: Following the surgery, elastic bands may be required on orthodontic braces to guide the bite into the new position. In rare instances where the bite adjustment is not optimal, a minor corrective procedure may be necessary to reposition the plates and screws. Sometimes these plates and screws will need to be removed in the future.

5. Change in operative plan: rarely the bones of the jaw may not split as they usually do, and alternative modalities may be required. This sometimes means using small (5mm) cuts in the cheek, holding the teeth together with tight elastic bands for several weeks, and in even rarer cases not continuing with the operation to split the jaw but to utilise a bone graft from the hip to promote healing.

After the Operation

Before leaving the hospital, you will receive a follow-up appointment scheduled for approximately one week after your surgery. Subsequent appointments will be arranged accordingly. Typically, patients are seen one week, two weeks, and four weeks post-surgery, in addition to routine orthodontic appointments.

Approximately six months after the operation, your braces will be removed. Retainers will then be provided to be worn on a nightly basis to maintain the results achieved.

If you have any concerns or require medical advice following your surgery, please contact our dedicated team 

We are committed to providing exceptional care and delivering transformative results in skin cancer and facial surgery. Serving Cheshire and Shropshire, our experienced team is here to guide you through every step of your journey towards a healthier and more confident you.

Note: The information provided is for general purposes only and should not replace professional medical advice. Please consult with a qualified healthcare professional for personalised guidance regarding your specific condition and treatment options.