Chin (genioplasty), cheekbones & jaw surgery
If you are considering facial surgery there are some questions that you'd probably like to be answered.
Basically, facial or orthognathic surgery involves the use of facial implants or repositioning of your facial bones (osteotomies) to improve and enhance your facial contours. Frequently, these procedures will help provide a more harmonious balance to your face and features so that you feel better about the way you look. Osteotomies are most frequently used to lengthen or advance the chin. Implants are manufactured from a variety of materials. They can help to:
- Strengthen your jaw line
- Bring the chin or cheekbones into balance with the rest of your face
The following frequently asked questions and answers (FAQs) help to explain about some of the facial implants currently available as well as the techniques for their use. While they may not provide the answers to all your questions, your surgeon at LPSA will be happy to discuss any further concerns you may have.
What should I consider before having facial surgery?
Facial implants can enhance your appearance and bolster your self-esteem. As long as you are looking for improvement, not perfection, in your appearance and are realistic in your expectations, you may find that a facial implant is the right choice for you. In cases of a retruded chin, osteotomies offer a natural alternative that avoids the small risk of implant complications.
Plastic surgeons will frequently use such implants or osteotomies to bring better balance to the features of a younger patient. For instance, a teenage girl may want her nose reshaped or her chin brought forward (chin advancement) so that these traits are better proportioned. The more mature patient may choose to have an implant placed in conjunction with another cosmetic procedure, to rejuvenate the chin pad that recedes with age. Modern fat-grafting techniques are also useful in modifying facial contours. For example, during a face lift, a patient may wish to have fat grafts placed over the cheekbones to help restore a more youthful appearance.
How do I plan my surgery?
Your plastic surgeon at LPSA will help you determine what it is possible to achieve and how best to do so. It may be helpful to provide him with photos of people who have facial features similar to those you would like to have. He will also take you through the details of the proposed surgery, including the cost and what to expect during your recovery.
It is important that you inform your physician if you smoke or if you have any dental or gum problems.
In preparing for your surgery, be sure to find out if you'll be able to drive home afterward or will require transportation. You should also ask if you will need to refrain from eating or drinking the night before your surgery, and if you should stop taking any medications, including aspirin and similar drugs. You may be instructed to take oral antibiotics both before and after the procedure to help guard against infection, and you should plan on eating a soft diet during the early period of your convalescence.
Your plastic surgeon will provide information about these important matters during your pre-operative consultation.
Where will my surgery be performed?
The surgery is performed at one of several of London's best private hospitals, according to your preference and the availability of operating time. You will usually be admitted on the day of surgery, and stay until the early evening. Occasionally, an overnight stay will be indicated. You will need a friend or relative to accompany you home after your stay in the hospital.
What type of anaesthetic will be used?
Facial surgery at LPSA is usually performed under a general anaesthetic, so you'll sleep through the entire operation. Newer types of anaesthetic that reduce the risk of nausea after surgery are used at LPSA, and the experience is usually safe and comfortable.
What takes place during the surgery?
There are many options available in facial surgery and your surgeon at the LPSA will talk through the details of each to discuss the one that is best for you. These are the general procedures for each type of facial surgery:
Chin Surgery
During this procedure, the surgeon selects the proper size and shape implant to enhance your appearance and inserts it into a pocket over the front of the jawbone. The small incision to create the pocket and insert the implant is placed inside the mouth (along the lower lip) or in the skin just under the chin area. Occasionally a small fixation device is used to stabilise the implant in its pocket, which is not visible through the skin.
Usually, the chin is taped after surgery to minimise swelling and discomfort. Sutures in the skin will be removed in five to seven days. If an intra-oral incision is used, the sutures will dissolve. Insertion of a chin implant may take anywhere from 30 minutes to an hour.
If an osteotomy is planned, the access is from inside the mouth. The beneficial effects of surgery are immediately apparent after the operation, and bruising is usually minimal. Again, the chin is taped after surgery for up to ten days.
Cheek Surgery
When cheek implants are being placed in conjunction with another cosmetic procedure, such as a face lift, forehead lift or eyelid surgery, the implants may be inserted through the incisions made for those procedures. Otherwise, an incision will be made either inside your upper lip or your lower eyelid. A pocket is then formed and an implant is inserted. After surgery, a dressing will be applied to minimise discomfort and swelling. The severity and duration of such side effects may vary, especially if another cosmetic procedure was performed at the same time.
Cheek implant surgery usually takes about 30 to 45 minutes.
Lower Jaw Surgery
Internal incisions are made on either side of the lower lip to provide access for creating a pocket into which the lower jaw implant can be inserted. Dissolving sutures are used to close the incisions. Insertion of a jaw implant usually takes about one to two hours.
How long will it take for life return to normal?
With any facial surgery, you may feel and look better within a short period of time. However, it may not be advisable to participate in any activity that may result in your face being jarred or bumped for several weeks. It's best to check with your plastic surgeon about such matters.
Recovering from chin surgery
You will experience some discomfort and swelling in the affected area for several days. It is normal to experience some temporary difficulty with smiling and talking. Black and blue marks may be visible around the chin and neck. Your plastic surgeon will instruct you about dental hygiene, eating and any restrictions to your activities after surgery.
Recovering from cheek surgery
Your surgeon at LPSA will provide you with instructions about post-operative care. There will be dietary restrictions as well as limitations to your activities. Again, these instructions will vary, especially if another procedure was performed along with your implant surgery. However, you should be aware that your ability to move your mouth and lips may be diminished temporarily. Stitches used to close the incisions inside your mouth usually dissolve within about 10 days.
Recovering from jaw surgery
Swelling is sometimes significant immediately following surgery, usually peaking 24 to 48 hours afterwards. Although most of the significant swelling will subside over a period of several days, prolonged mild swelling may prevent your final facial contour from becoming apparent for several months.
During the healing phase, your activities and diet will be restricted. Your ability to smile, talk or move your mouth in any way may be limited for several days to weeks following surgery. Your surgeon at LPSA will instruct you about dental and oral hygiene during your recovery.
How will I feel about my new look?
Give yourself plenty of time to get used to your new look, as you may not be able to accurately evaluate your appearance for weeks, perhaps months.
You may be surprised to find that most people won't recognise that you have had facial implant surgery - only that you look better.
Does facial surgery carry any risk?
Problems with facial surgery occur only rarely, but it is important to be informed about such possibilities. This website will touch upon a few, but is not intended to provide a detailed or complete inventory of potential risks.
A facial implant can shift slightly out of alignment and a second operation may be necessary to replace it in its proper position. Infection can occur with any operation, if infection were to occur around a facial implant and did not clear up after treatment with antibiotics, the implant might have to be temporarily removed and replaced at a later time. Other, less frequent, risks may be associated with certain implants.
Your plastic surgeon will be able to give you a fuller description of the risks associated with the procedure in which you are interested, particularly if you are weighing up a chin osteotomy against a chin implant. Transient numbness of the lower lip may occur after an osteotomy, but usually recovers within a few weeks.
Some of the implant materials are made of a solid silicone. Currently, there is no scientific evidence that this is a harmful substance. Your plastic surgeon at the LPSA will be happy to discuss any current scientific findings concerning the type of implant you're considering.
