Mandibular Angle Reduction

Mandibular Angle Reduction

The shape and contour of the jawline are determined by the chin in front and the mandibular angles at the back. Prominent mandibular angles make the lower jaw appears square and masculine. The prominent mandibular angle can be either due to the hypertrophy of the masseter muscle or enlargement of the angle of the mandibular bone. Hypertrophy of the masseter muscle can be managed effectively with botulinum toxin A injection. If the prominent jaw angle is caused by the enlargement of the angle of the mandibular bone, then mandibular angle reduction surgery is performed to reduce the enlarged mandibular angle.

Preparation

1. 1. 1. Pre-operative analysis of the mandibular bone by X-ray or CT scan is required.

      2. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

      3. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.

      4. Stop the following medications and supplements from one week before surgery until one week after surgery.

         1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.

         2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.

      5. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

Surgery

Duration: 2-3 hours

Anaesthesia: General anaesthesia

Hospitalization: At least one night stay

Recovery*: Back to work 1 to 2 weeks, light exercise after 2 weeks, heavy exercise after one month* The actual speed of recovery may vary from person to person.

Surgery Technique: An incision is made inside the mouth, and the mandibular angle is exposed. The reduction of mandibular angle is carried out by burring or by resection of the protruding bone.

Post-operative Care**

1. 1. 1. What to expect:

         1. Swelling usually peaks on the second to third day after surgery and will gradually subside after that in 2 -3 weeks.

         2. Drains usually are placed inside the mouth for one to two days.

         3. Use a compression garment is required for 2-3 weeks

         4. Avoid hot foods and hot drinks for at least 3 days. Take soft diet and drink a lot of water.

      2. General care

         1. Apply cold pack first 3 days and warm pack after that. Elevate the head during sleep to reduce swelling.

         2. Avoid smoking for at least one month. Smoking increases the risk of wound complications.

         3. Adequate rest and sleep are helpful for a speedy recovery.

         4. Be relaxed and calm. Contact the clinic if there are any queries.

      3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller as prescribed when necessary.

      4. Wound care: Regular gargles with normal saline.

      5. Physical activity: Avoid heavy physical activity and exercise for at least one month.

      6. Follow-up: Come back one week after surgery for review.

      7. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.