Mandible contouring or mandible reduction is a procedure that benefits patients who desire a more refined and smaller jaw and chin in Jupiter, West Palm Beach, and Palm Beach County, Florida. It is performed by Dr. Vartan Mardirossian at the Mardirossian Facial Aesthetics fully licensed surgical suite in Jupiter, FL.
What is Mandible Contouring?
Mandible contouring is the reduction in size and the refinement of the chin and the jawbones on both sides. The procedure benefits patients who have protruding mandible angles and a square chin, and would like those facial features to be smaller and more refined.
How is the Female Mandible Different from the Male?
The shape of the mandible is a feature of the face that can influence and determine gender perception. It is known that women have a softer, narrower contour to their jaw and chin, whereas men have a wider jaw and a squarer chin.
Some women, however, complain of having a wide jaw and request a mandible contouring procedure. Mandible contouring surgery gives the face a more feminine look and may
increase the attractiveness of the face.
Am I a Candidate for Mandible Contouring?
If you feel that your jaw angles are too prominent or your chin is too high or square in shape, then you are probably a candidate for mandible contouring. The mandible anatomically includes the chin and the body and the angle of the jaw, so mandible contouring in our practice typically includes the reshaping and reduction of all those parts.
There are several important points that need to be considered prior to the procedure:
- Is there a potential need for orthognathic surgery or orthodontic work?
In some cases, the patient presents with problems such as malocclusion and mandible overgrowth that can be best addressed with a procedure that combines the improvement of the mandible aesthetics with the improvement of the masticatory function. In those cases, our cooperation with an orthognathic surgeon is essential for the success of the procedure. A bilateral sagittal split osteotomy can be combined with a sliding genioplasty and/or with an angle resection.
- What is the quality and thickness of the soft tissues?
In patients over 40 years old with heavy skin, there is a chance that a facelift and neck lift may be needed in combination with the mandible contouring surgery. Our practice will always be transparent with patients to keep them informed about this possibility.
- What are the objectives for the position of the chin and the mandible angles?
The chin bone should ideally be at an imaginary line passed vertically down from the point where the nose meets the forehead, up to 2 mm in front or posterior to it. Another way to establish its ideal position is considering the soft tissue of the chin to be ideally situated 2-3 mm posterior to the lower lip outline in profile. The aesthetically pleasing mandible angle should ideally be about 1 cm anterior and 2 cm inferior to the earlobe.
How is the Mandible Contouring Performed?
The procedure is performed under general anesthesia. The mandible body and the chin are accessed through incisions in the mouth. During the mandible contouring procedure, a smoother and narrower mandible angle and body shape is achieved along with a reduction of the prominence, height, and width of the chin to create an attractive, harmonious appearance.
Despite being performed through fine hidden incisions, the mandible contouring involves manipulation of deep tissues of the face, including important vessels and the nerves that move and collect sensation from your lower face. To avoid unnecessary risks, make sure you trust your face to an expert in the field like Dr. Mardirossian when considering this procedure.
What Are the Types of Mandible Contouring?
There are two main types of mandible contouring procedures. One is the mandible contouring by bone shaving (or corticectomy), while the other one is the mandible contouring by osteotomies (or bone cuts). Each method has its advantages over the other one and many times we actually combine the osteotomies and the bone shaving to achieve the best aesthetic result. Here is a list of the various procedure types:
The great advantage of this method is the possibility of increased bone removal in a more symmetrical and reliable fashion. A relative disadvantage is that hardware is left in place to reconstruct the structure of the chin. This is a risk and therefore needs to safeguard the inferior alveolar nerve and its canal. For that reason, a preoperative CT scan is warranted.
Another consideration is the necessity for a facelift and neck lift in some patients older than 40 years, in which the removal of a significant amount of bone can lead to soft tissue sagging.
There are two distinct types of mandible contouring with osteotomies:
The chin bone is severed in a precise geometrical pattern (sliding genioplasty), which allows for the removal of a central portion of the chin and re-approximation of the remaining bony ends. This is an extremely versatile procedure as it allows for a potential refinement, reduction of the chin height, advancement, or setback of the bony chin.
The remaining jaw bone is then removed along a precise line that creates a smooth lower border for the jaw. This also includes the removal of the excess bone at the mandible body and angle. This procedure is best fitted for patients with broad and or prominent chin and prominent mandibular angles and body.
Mini V-Line Surgery
The chin bone is managed exactly as in the case of the V-line surgery, however, the additional bone removal is only at the level of the mandible body and does not involve the angles. The angles can be additionally shaved to decrease their inferior and lateral prominence. This procedure is great for patients with a prominent chin but angles that are not prominent.
Mandible Contouring with Corticectomy
This technique includes the removal of the mandible cortical bone in a uniform fashion after the soft tissue has been extensively dissected from the jaw bone. The chin bone and the bone of the various segments of the mandible are gradually removed with the help of a special powered instrument.
The advantages of this method are that there is no need for hardware placement and there is almost no risk of facial tissues sagging after the procedure, given the more modest reduction in the mandible size. No bone can be shaved beyond the cortex; therefore, a disadvantage is the smaller amount of bone removed when compared to the other methods, mainly because the thickness of the cortex ranges between 3-4 mm.
Another challenge with this method is achieving perfect symmetry between the two sides of the mandible. This procedure is best fitted for those patients that only require a smaller amount of bone removed.
How Long Will My Mandible Contouring Results Last?
The result of the mandible contouring is permanent. This is an advantage over the reduction of the jaw muscles with Botox® injection, where the results can last only up to six months.
What is the Recovery Like After Mandible Contouring?
Swelling may persist for several months following a procedure, although the bulk of the swelling typically resolves in two weeks. The new mandible contour will start being visible for four to six weeks post-surgery. This is because the internal swollen tissue may take additional time to resolve, and the skin may take time to naturally re-adjust to the contour of your new jawbone.
A soft dressing is worn around the jaw and the head for the first seven days to help with the swelling. The stitches are self-absorbing, so they do not need to be removed. An antibiotic mouth rinse and oral antibiotic and pain medications are also important for the patient for the first seven days following the procedure. In the meantime, the patient should also avoid hard food. Soup and soft foods are best during recovery time. You will be given detailed postoperative instructions during your preoperative visit.
Contact Mardirossian Facial Aesthetics today to schedule a consultation with Vartan Mardirossian, M.D., F.A.C.S., to see if this procedure is the right solution for you. We offer mandible contouring to patients in Jupiter, West Palm Beach, and Palm Beach County, Florida.