Frequently Asked Questions (FAQ) About Jaw
Augmentation - Jaw Implant Surgery
1. What is a Jaw Augmentation?
2. When can a Jaw Augmentation be performed?
3. What does a typical Jaw Augmentation consultation entail?
4. How is a Jaw Augmentation performed?
5. What should I expect post-operatively?
6. When will the stitches be removed and does this hurt?
7. When will I be able to see the results?
8. What are the risks of Jaw Augmentation?
9. What is Arnica montana and/or Bromelain, I have heard that these
homeopathics reduce swelling and bruising? Which is the best kind to take?
10. Are the results permanent?
Also known as mandibular
augmentation is the use of synthetics or biologicals to augment, or make the jaw
bone structure of the face more prominent. It can give balance to an otherwise
less defined face or further augment an already existent mandibular structure.
Usually anywhere from 20 years old and up.
After checking a
surgeon's background and credentials, you will make an appointment for a
consultation. You will meet with this surgeon and discuss your goals and
you will disclose all information regarding your health; if you smoke, what
medications or vitamins you presently take. This is very important. Visit the Medication
& Supplement List for more information. Your skin will be examined and
the elasticity will be determined. You will discuss your complaints and concerns
and discuss the various techniques and implants available to you. Your
surgeon will explain the technique and incision placement methods that may be
most appropriate for you. The surgeon should discuss the Risks
associated with jaw augmentation with you.
Do not let the
surgeon tell you that there are only one or two implants available. This surgery
is not a one size fits all type of thing. Knowledge is power -- so research
before your consultation. There are quite a few types, sizes and models, etc.
(although not near as many as malar implants). The above list is only a
few of the most popular brands and products.
You will also
discuss the available anesthesia that will be used for your procedure. Most Jaw
Augmentation procedures are performed under Light Sleep Sedation although some
surgeons may use General Anesthesia. Either way, discuss this beforehand.
do go under General, you make sure that the anesthesiologist is certified.
Please read the All About Anesthesia Page.
If you would like
more information on consultations or a list of questions to ask your surgeon
please visit the Consultation Help Page.
If you should choose to book or reserve a surgery date you will usually give a
deposit to hold your surgery date. Most times if you cancel a few days
beforehand, this amount is non-refundable. After paying your deposit and
scheduling a surgery date, you will also schedule a pre-operative appointment
Depending upon the amount of
augmentation and the technique and implant used, Jaw augmentation can last about
1 and 1/2 hours to 2 hours or more if reconstruction is needed.
First, you will have monitoring pads
attached to you so that the surgical team can properly monitor your vital
statistics before, during and after your operation. When you are brought
to the operating room, electrodes will be plugged into these pads
which are connected to the monitoring equipment.
Once you are on the operating room table, you
will then be given your choice or your surgeon's preference in anesthesia as
discussed prior to your surgery date. If you had been given an oral
sedative or valium prior you will have less anxiety. They will more than
likely insert an IV for a saline drip to keep you hydrated and have a vascular
doorway for anesthesia, antibiotics, and other medications. If
you haven't been given a sedative, it is more stressful for some patients.
If you feel that you may experience anxiety inquire beforehand regarding an oral
sedative. Having an IV inserted feels sort of like blood being drawn, but
for a shorter period of time. It's the initial placement of the IV that
may sting a bit. Some people get heir IV placed in the crook of the elbow,
some the hand -- it all depends upon your veins though. So if your
veins are not very prominent this can be a problem. You
are then brought to the O.R. if you aren't on the table yet. After
the needle is injected into the vein it is pulled out and a little plastic tube
is left in your vein. This is called a catheter. The
catheter is taped to your skin so it is not accidentally knocked or pulled out
and is ready to be used as a sort of entryway for anything the surgical team
deems necessary for your body. This is usually done before you get into
the actual O.R. - by a nurse - and you have a saline bag hooked up to you.
The medications will usually be given with a drip system with this saline. As
said before, the saline will keep you hydrated both during and post-operatively.
If you have chosen
an IV Liquid Sedative, they will insert a hypodermic into your tube that you are
attached to or they attach the bag of it with a drip system to add a few drops
every few seconds and when they spring open the stopper and it starts heading
towards your body. The the effects of the anesthesia are felt soon after
injection or opening the stopper -- a few seconds in fact. It may feel
similar to a sensation of heat entering your arm or hand at the
catheter site. It then feels as though it is creeping up your arm - then
it jumps from your shoulder to a metallic-like taste under your
tongue and then you are blissfully anesthetized. The
anesthesiologist or surgeon will then determine if you are sedated properly,
your stats are stable and if you are ready for the surgery to begin.
You will then be marked with a
magic marker type pen which helps the surgeon determine the placement areas.
You will then be scrubbed with Betadine, the surgical marker markings will
remain, although not as dark. You will be injected with a solution of
Lidocaine, epinephrine and saline. The epinephrine is a vasoconstrictor.
This will impede your skin's ability to bleed excessively.
The incision will be
made in the predetermined placement, the implant situated directly on top of the
bone (or right on top the overlying tissue covering it and either sutured or
screwed into place. It may take several tries as the implant is usually
customized to your facial structure for comfort and aesthetics.
The surgical team then performs a
sponge and instrument count and your surgeon then closes your incision with,
more than likely, a non-dissolvable type suture.
percutaneous sutures are used but only very rarely with jaw augmentation.
This is normally reserved for malar implants. This is where the sutures
stick partially out of the skin and can be removed later on by tugging gently on
them after they have partially dissolved within. They can also be sutured
with dissolvable stitches inside the surrounding tissues. Even still, they
may not be sutured at all, relying on your body's collagen to secure into place.
If no internal sutures are used you will more than likely wear your tape or a
head wrapping longer unless the pocket specifically fits your implant snugly.
This wrapping will be worn post-operatively during the day for the recovery
period and is worn at night to help it heal properly in the face per your
surgeon's instructions. If you are not familiar with this look it involves wrapping a dressing around the top of your head to
underneath your jaw, sometimes slightly over your ears. Of course there
may be differences in surgical technique depending upon the preference of your
You are then gently
awakened and brought into the recovery room where the recovery nurse will
monitor your vital stats until you are ready to be released. This is
dependent upon the individual but may take up to two hours. Your face may
feel tight and quite tender as the anesthesia wears off. You may even feel
emotional or upset -- this will depend upon your body's reaction to
anesthesia. You may also experience rigors or shivering.
This may feel uncontrollable and is usually from the medications, more
than likely epinephrine that is used as a vasoconstrictor. The recovery
nurse usually has wrapped you in a warm blanket but if not, request one.
It certainly makes things more tolerable. You may even be fortunate to
have heating lamps.
Some patients feel
nothing different although if you have had General you may feel a little sick,
hopefully your surgeon gave you something to lessen this. Your prescribed
medication should alleviate this pain and discomfort. However, if you
believe your pain to be out of the ordinary once you get home, call your surgeon
or the on call staff immediately. You will be driven home by your spouse,
significant other or friend as you will not be able to see, much less drive
You may be
groggy from the anesthetic and/or oral medications and probably won't remember
much of the first day or two. You will have to take it easy and sleep on
two pillows to keep your head elevated for 7 to 14 days - or however long your
surgeon suggests. When you wake up you will notice that your face will
look even more swollen in the first 3 days. But, as the days go on the
swelling will dissipate. There may be bruising, but this will go away, as
well. So make a mental note of this or you may be shocked into a
depression. Bruising and swelling are a normal occurrence in most
You will more than
likely experience some discomfort for several weeks - having had intra-oral
incisions your diet may be restricted. You should make certain all fresh
fruits and vegetables have been washed, no raw fish (sushi), very rare meat or
other types of foods that may contain high amounts of bacteria. Eating
foods such as this may increase your risk of infection due to the incisions
being in the mouth. You may be instructed to rinse with Listerine several
times a day. DO NOT PICK or tongue your incisions or sutures!
discomfort should be alleviated by your prescribed pain medication if you have
excessive pain, redness, pus or other symptoms that do not appear normal,
contact your surgeon immediately! Take your temperature regularly.
An elevated temperature could mean an infection. Take those antibiotics on
time. Also, don't forget if you are a female taking birth control pills that
some antibiotics can interfere so in the event that you do have relations, use
another form of protection as well.
Even though you may
feel better, you must take it easy for the first 3 weeks. Be careful not
to bend over or lift heavy objects. And be careful not to raise the blood
pressure for at least 3 weeks as this could cause internal bleeding at your
treatment area. Your blood vessels dilate to allow increased blood flow
when you raise your heart rate. This may cause problems at internal wound
sites. Do not participate in contact sports for at least 6 to 8 weeks
although ask your surgeon what he recommends specifically.
You may notice a
change in your smile, odd sensations of tightness, tingling, the
sporadic sharp pain, or pulling, burning, and cold sensations.
These usually subside within the first few weeks but the remainder of the
swelling will take months to dissipate. Just know that your swelling will
subside, revealing a more defined jaw structure and a more youthful,
proportionate you. Although this may take some time so please prepare yourself
emotionally. Some patients experience a lull or down period
where they become depressed or feel unattractive. This is very normal.
Please see our Emotional
Preparation Section so that you will be able to remind yourself that you
will get through your low period.
If you had non-dissolvable
sutures, these will more than likely be taken out by your surgeon at a week to
10 days postoperatively. If
you had dissolvable sutures, this will dissolve in about 10 days.
The results are immediate, in fact you may
believe that you have received too much augmentation and demand that your jaw
implants be taken out. This is a common emotion and you must wait until
you are fully healed to determine if you dislike your new jaw line. There
is significant swelling with jaw augmentation so please be advised of this fact.
Just know that your swelling will subside, revealing a more defined jaw
structure and a more youthful, proportionate you. Although this may take some
time so please prepare yourself emotionally. Some patients experience a lull or down period where they become depressed or feel
unattractive. This is very normal. Please print out our Emotional
Preparation Sheet so that you will be able to remind yourself that you
will get through your low period.
surgery as risks and complications. With jaw augmentation, these include
allergic reaction to the anesthetic used, please see the Introduction
to Anesthesia section for more information. You may also develop an
infection (the implant must be removed for 3 months, you must take your
antibiotics diligently and then and only then can you have a secondary surgery.
There could be asymmetry, malposition, dissatisfaction, hematoma or seroma.
There is also the risk of shifting. If this happens a second
surgery may be needed to reposition the implant.
Also, to ease your
fears...there is no conclusive evidence with autoimmune disorders regarding
silicone toxicity, rheumatoid arthritis and the like. Solid silicone facial
implants have been used for decades in cosmetic applications without any ill
also known as:
Tobacco, Mountain Arnica, Common Arnica, Leopard's Bane and Sneezewort
plant family: Asteraceae
type: Herbaceous perennial
parts used: Roots and flowers
description: Arnica montana or Leopard's Bane is a perennial herb,
growing close to the ground. The leaves form a flat rosette, from the center of
which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers. The
rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry
rootlets on the under surface.
habitat: Indigenous to Central Europe, in woods and mountain pastures,
although it has been found in England and Southern Scotland.
warning: This herb should NEVER be taken in raw form. This plant, like
many medicinal plants if ingested, can cause intestinal bleeding, abdominal
cramping and sickness. Homeopathy is the medicinal use of tinctures and
suspensions using herbs and other plants and should never be consumed without
proper preparation. Only respectable homeopathic remedies and tinctures should
from the plant of the: Pineapple
also known as: Ananas, Nanas, Pina
plant family: Bromeliaceae
parts used: mostly in the stems of pineapples, but some fruit is used as
description: 2 1/2 to 5 ft. high with a spread of 3 to 4 ft. The plant is
like a thick stem with a rosette of wide, waxy leaves. These pointed
green, red, and white/off white striped leaves are approximately 18 - 70 inches
long and graced with a spiny needle-like tip.
plant produces a sweet to tangy and sometimes sour fruit that is yellow to white
in color. The unpeeled fruit is brownish with a hard, spiky covering and a large
green sprout from it crown. The fruit is shaped like a coffee can with rounded
ends and is about 10-12 inches long usually when considered prime and may even
weigh up to 10 lbs.
to southern Brazil and Paraguay, The fruit
is now grown all over in green houses and in the fields of Spain, Guatemala,
Hawaii and more. The pineapple is a tropical plant and thrives in hot, humid
places. Although it can survive cold snaps, it is not recommended for the more
northern areas if intended to be grown outdoors.
Bromelain is an anti-inflammatory formula
containing the proteolytic enzyme from the stems of pineapples.
Proteolytic enzymes are capable of dissolving proteins. It is most often used
after sports injuries, to relive edema and after surgical procedures to help
ALWAYS ASK YOUR SURGEON FIRST
BEFORE TAKING ANY MEDICATION.
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Are the results permanent?
Yes, jaw augmentation is permanent
unless an unforeseen problem (such as infection or extrusion) occurs creating
the need for removal.
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