Facial Bone Surgery
Author: Michael Russell
The premaxillary portion of the facial bones (the upper jaw) just below the nose may protrude or recede too much for an attractive appearance. While some correction can be obtained from an orthodontist, if the malocclusion is severe, maxilloplasty, the surgical recession or advancement of the bone itself, may be advisable. This surgery needs extensive care than most cosmetic surgery procedures. While it does in fact improve the patient's appearance, maxilloplasty does not generally come under the heading of cosmetic surgery. Rather, it is sometimes considered reconstructive surgery because of its function, namely, proper occlusion of the teeth, is nearly always involved.
Severe malocclusion may also be corrected by mandibuloplasty, the resetting or advancing of the mandibular (lower jaw) bone. Frequently, the addition of bone, cartilage, or some type of silicone implant is used to bring the chin forward to achieve better facial balance.
This surgery is often performed in conjunction with a rhinoplasty, making possible the use of the bone and cartilage removed from the nose for the reconstruction of the chin. As an additional procedure accompanying a face lift, it is especially valuable to the individual whose chin has receded excessively because of the premature loss of the lower teeth.
Chin surgery (mentoplasty) is undertaken under local anesthesia unless it is necessary to obtain bone from some other part of the body. The incision is made either inside the mouth or just beneath the chin, where the scar will be inconspicuous. The incision beneath the chin is used for the removal of excess bone to reduce an excessively long or prominent chin. After the operation, the patient is limited to a soft diet for about ten days. While complications are rare, a nerve may be damaged, producing numbness and lack of mobility of the lower lip either temporarily or in rare instances permanently. Another postoperative complication may be the deviation (separation or slippage) of the material inserted. This is corrected by a secondary adjustment.
The appearance of some women is enhanced by malarplasty, the augmentation of the molar eminence of the cheekbone. Bone or block silicone is inserted to achieve greater prominence of the cheekbone. The incision may be made in the mouth, through the lower eyelid, or behind the hairline in the area above the ear. A pocket for the insertion of the implant is created by separating the overlying tissue from the bone beneath. If the inserted material drifts, it may create a grotesque effect. In thin individuals, it may be apparent on close inspection.
Six months after surgery, recovery is usually complete and the maximum effect on appearance is attained. Of course, there are individual variations due to heredity, age, quality of the skin and general health. At that time, additional minor surgical correction may indicated in order to achieve optimum results. In the 40 to 50 age group, the time at which this surgery is most commonly undertaken, both the skin and the underlying adipose (fatty) tissue have already begun to lose their elasticity. The facial and cranial bones have began to decrease in size. For these reasons, among others, not all wrinkles can be removed and a face lift should not be undertaken with that expectation.
Michael Russell
Your Independent guide to Cosmetic Surgery
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