The Procedure

What is the procedure ?

The jaw or mandible is the facial bone which is located on the below part of the face. The size of the jawbone determines the width of the lower face. If the bone is thick and wide or the muscle is thick and bulky, it will result in a widened face. The bones in of the woman are typically thinner than the man as anatomical structure, especially the back angles below the ears and the ridge along the lower edge. If you look from front view, the female facial will be narrower at the bottom like triangles the chin as its lower point, but in the male facial will look squarer. This is the reason why so many peoples especially, in Asian peoples seeking for the procedure to improve the jaw line to make it symmetry with the rest of the face to make the face look more slender and feminine feature or generally known as “V Shaped face appearance”

So, Jawline or mandibular reduction procedure is the procedure to support this demand in the people with very width jaw angle, reduction the size of the lower part of the face, making it rounder and more narrow at the square corners near the back of the jawbone by pulling the bone down and some part of the muscle will be removed without getting injured, the muscle still can work well in order to make the oral face appearance which is look rounder and softer. And normally, jaw line reduction is always performed combining to chin surgery (chin contouring or chin implant) to make the face look more balance and the more prominent mandible appear.

Additional jawline reduction can be performed with Botox, weakening it so it slowly becomes smaller. But the result is very little visible and not permanent, you need to re-inject the chemical in every 6 months.

The Method

How the procedure is performed ?

The procedure will be performed under the  general Anastasia to make the patient sleep during the surgery  with 2 locations of the incision ,  inside and outside the mouth.

Inside the mouth incision

The insicion will be made inside the mouth between the gum and cheek to access the mandible (jawbone) to be able to reach the mandible and shape it with the with special electric drills , make it rounder and smaller and also the masseter muscles (the muscle which control the mandible moving ) will be removed in the same times. Due to this also can cause of the width mandible appearance. And when the mandible is contoured and the muscle is removed in the sufficient amount, the incision will be closed with the sutures and the small tube will be inserted into your mandible to drain out the liquid from inside to prevent any potential blood collection and shorten the period of postoperative swelling.at the final step of the procedure. This technique is the common technique that most of the surgeon performs. Due to the incision will be invisible inside the mouth.

Outside the mouth incision

The surgeon will make an incision outside the mouth, in the location near the outer corner of the jaw, about 3 – 5 centimeters of the length, cutting into the muscles to access mandible in order to shape it to become smoother and curved with the medical sawing device and also, the masseter muscles (the muscle which control the mandible moving) will be removed in the same times. And then, the surgeon will close the incision with the suture. But this technique of the jaw line reduction the surgeon will close the incision with the suture and the small tube will be inserted into your mandible to drain out the liquid from inside to prevent any potential blood collection and shorten the period of postoperative swelling. But this technique of the jaw line reduction is the risk to damage the mouth nerve which leading to the corner of the mouth may be disrupted.

What type of Anastasia is necessary for the procedure ?

General Anastasia

How will the incision look like?

The incision of Jaw line reduction procedure can be made in 2 places, inside the mouth and outside the mouth. If the incision is made inside your mouth, it will be completely invisible. But the incision will be start at bottom gum along to the jaw line (mandible). But if the incision is made outside the mouth, the incision will be made at the corner of the jaw area, about 3 – 5 centimeters of the length.

Ideal Candidates

Is this procedure suitable for the candidate ?

  • The candidate of jaw line reduction can be male, female or transgender either but must be in the good health ,no serious medical problems which can’t have the major surgery 
  • Over 18 years old of the age, when the body is already stop developing
  • The people who have the lower part of the face much wider than the upper part caused of the square shaped mandible and want to reduce it
  • The people with the protruding mandible and want to correct the shape of this
  • The people without the neuromuscular and active dental disorders
  • The people who want to have V-Shape face appearance 
  • The people who feel the face appearance is very strong as the male and want to make the face softer and curved 
  • The male transgender want to have the feminization face as the real woman 
  • The people who understand well about the procedure such as the result of the surgery, the risk and complication or the side-effect.
  • The people with the stability mental or good patiently. Because it will take a several months to get the final result of the surgery. The patient may get stress during this time
  • The people who want to increase the self-esteem and feminization appearance

What are the results the candidate can expect?

  • The result of the surgery is visible and permanent 
  • The face look more beautiful oval shape as we knows “V-Shape”
  • The lower part of the face look more slender, triangle or square face is disappeared
  • The jaw line angle is more curved, look rounder and narrower as he female face 
  • The whole face structure look more balanced and shaped
  • The face appearance in women look sweeter, in man look more symmetry
  • Obtained the self-confidence and self-esteem from new face which is more balanced.
  • The incision is visible ( in case the incision is made inside the mouth)
  • For the transgender who undergo the jaw line reduction can go further to another feminization procedures
  • The final result of the surgery will be occurred after 3 months or a year 

Recover/Post-Operative

Length of stay at the hospital and in Thailand

1-2 nights in the hospital, recommends 12 days in Thailand

Pre-operative care

  • Before the surgery can happen, you need to have a consultation with the surgeon and inform them all information about your medical problem, your allergies , medical you are taking
  • You should tell the surgeon about the expected result of your surgery to see that it’s realistic to do or not, measure the width and the length and any corners of the facial bone including planning the surgery method 
  • The surgeon also needs to inspect your facial bone and the soft tissues by X-ray or Radiological assessment (Facial X-rays or CT scans) ad also check the cause of high volume of the cheek, it’s because of the bone or fat tissue
  • Be sure that you understand the surgery clearly, which technique of the surgery the surgeon will perform with you, the complication, the incision and etc
  • You will be asked to stop taking Aspirin, ibuprofen, and products containing aspirin and ibuprofen may inhibit blood clotting and cause bleeding problems during and after surgery including anti-inflammatories medication and including high dosing any multivitamins/herbal remedies/teas etc. that contain high levels of Vitamin E, Ginseng, Ginko and fish oils before and after the surgery for 2 weeks because there can thin your blood
  • Stop smoking and drinking all kinds of alcohol before and after the surgery for 2 weeks also, this’s effect to delay wound healing after the surgery
  • You should drink a lot of water because of the surgery, you may feel very thirty

On the surgery date

  • And on the surgery date, you should stop eating and drinking 6 hours before the surgery 
  • Take a bath and wash your hair wash your hair and clean inside your ears with the cotton bud. But do not apply the lotion and cream on the body including no makeup
  • Take out all accessories, such as earring and also remove the nail polish before getting the operation room
  • Wear the loose cloths or comfortable, If possible take the shirt with the button in front
  • Sleep well before the surgery
  • Make a physical checking up to be sure that you have the normal level of your blood pressure or any disease come up which can’t undergo the surgery or not

Post-operative care

  • After the surgery, you may feel difficult to open the mouth , but it’ because of the swelling and will go away over the time 
  • If you feel pain, the painkiller pill and antibiotics medication is recommended if the pain is extremely and for preventing to get infection during the healing process and continue taking them until they are all gone
  • The surgeon will recommend you lay down in the position with your head higher than body. This will help relieve pressure from your treatment area. This will help relieve pressure from your treatment area reducing swelling and pain
  • The surgeon will recommend applying the cool pack or frozen peas, this can reduce the swelling and stop bleeding (especially, the first few days is recommended to keep cool pack on your surgery area all the time) and including vitamin A and C is also can help
  • You may be recommended to use the compression garment to support the surgery area (your cheek)
  • During the recovery time, try to drink water as much as you can 
  • Stop eating after the surgery date at least 24 hours to avoid getting infection from the bacteria in the mouth and keep eating the soft food until 2 weeks after the surgery and continue avoiding strong food or sticky food or the uncooked foods, fresh fruits or vegetable which maybe have the bacteria contained until 4 weeks. Because this is risky to make your incision get infection
  • Try to drink water as much as you can but in the contrary hand,oral antibiotics and analgesics are recommended to do as often as you can 
  • Keep all incision and suture lines free of moisture to ensure proper healing. Do not allow creams, lotions, or topical arnica into the incision because they can cause inflammation 
  • You may notice a change in your smile, tingling, the sporadic sharp pain, pulling, burning, cold or other unusual sensations. These usually subside within the first few weeks. Your end result is usually seen within 4 months
  • Don’t try to touch the incision and the wound with your tongue because it can make the incision separate from each other.
  • About 7 days after the surgery, you have to come back to see the surgeon again for follow up checking to be sure that the incision go well, no side-effect or complication.
  • You can resume light activity the day of surgery. Do not lifting heavy objects and, especially, no bending over to lift objects. Its can caused of raising your blood pressure and heart rate through strenuous which this can slow-down the healing process .
  • Avoid extreme activities or strenuous sport at least 3 weeks because of the rising high blood. This can cause of bleeding inside your cheek.
  • Healing the wound after the suture is removed can be enhanced using micro-pore tape, moisturizing creams, massage, vitamin E, steroid injections, and silicone sheeting
  • You can start walking again after the surgery as much as you can to avoid the blood clots but do not make the extreme exercise which can disturb your incision such as running or any activities that you have to put your head up and down which and be effect to the blood pressure but the extreme activities or strenuous sport should avoid at least 3 weeks because of the rising high blood

What are the possible risks and complications involved?

The common symptoms

After the surgery, you may feel pain, swelling and bruising, uncomfortable including numbness. But all these symptoms will fade away in a few weeks. And you will be able to see new natural facial appearance in 3-6 months after the surgery

Infection

Normally, the surgeon will let you take an antibiotic pill both of before and after the surgery for prevention getting infection from the operation. But if the bacteria is so strong or you don’t take the right antibiotics, this problem still can happen which you can notice from the redness occurs surrounding your incision ( in case the incision is outside the mouth), the strong pain, bleeding or oozing from the incision or high flu. This you should go back to meet the surgeon again as soon as you can to get the right treatment

Asymmetry

The result of the surgery is not equal between the both sides of the jaw. Sometimes, it’s happen because the surgeon’s performance. But sometimes, even though the surgeon marks the concern area very careful there may be asymmetries. Because by anatomically, the facial face structure of the human is always having little flaws, a little asymmetry between one side and another side is normal. But when the surgeon takes out the jawbone in the same amount from each side, this can cause of asymmetry face. The revision the surgery is required if necessary

The nerve system has been damaged

Jaw reduction is one of the most serious procedures due to around the jaw area, it has the nerves that control the function of muscle expression around the mouth. And if they are injured from the surgery, it can lead to have the numbness on that area which can develops to be the temporary or permanent facial paralysis. But jaw reduction with the incision inside the mouth will be more safer an reduce the change of nerve injury

Blood clots

After the surgery, you maybe have bleeding from the cut bone or the swelling doesn’t go away over the time as it should be. This can be the cause of blood clots inside the wound. But inserting the smaller tube into your face to drain up any liquid or blood and wearing the compression garment can reduce this risk.