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Facial contouring

Square faces and high cheekbones(zygomatic bone) are a problem of abnormal facial proportions. Facial contouring is an operation to adjust the shape and of the facial bones, usually including the cheekbones and the jawbone(mandible ). Bone contouring, by means of osteotomy and internal fixation, moves the position and reduces the size of the zygomatic and mandibular bones so as to adjust the face proportion.

Correction of the relative position of the upper and lower jaws is most commonly used to treat occlusal problems that cannot be improved by orthodontic treatment alone due to skeletal abnormalities. Craniofacial reconstructive surgery is performed to move the bone and teeth together to the optimal position.

Preparation before surgery

• Discuss with an orthopedic surgeon. An orthodontist uses X-rays and dental casts to translate into the facial bone and tooth development and calculate the direction, distance, and angle of bone movement to work out a surgical plan. After making out the parts to be sculpted and confirming the operation date, go through the hospitalization registration. A chest X-ray, electrocardiogram and blood drawing are performed before surgery, while computed tomography is carried out as needed. If you find any problems after you return home, please write them down. If your family has any questions, please come to consult with your doctor. Good preoperative communication and preparation can help you achieve the desired surgical results.

Preoperative precautions

• Please do not smoke, do not stay up late, avoid cold, maintain oral hygiene one month before and after the operation. If you have special disease or take medicine, please inform your doctor in advance and stop taking gingko, grape seeds, vitamin E and other products that will promote blood circulation.
• Cooperate with an orthodontist in treatment as directed by your physician.

Anesthesia and surgery

• Facial contouring surgery is usually performed under general anesthesia. The whole process is carefully monitored by professional anesthesiologists and anesthetic technicians with precision instruments. For patients to be treated under general anesthesia, fasting after midnight the day before the operation. IV drips will be given in the ward or preparation room on the morning of the operation The operation time varies from 3 to 4 hours depending on its complexity.

Postoperative precautions

1. Catheters in the body after operation:

Generally, IV catheters and urethral catheters will be left after surgery. With the recovery of physical strength and the increase of food intake, IV catheters can mostly be removed after surgery. The urethral catheter, which is necessary for anesthesia, will be removed after surgery to avoid the inconvenience of getting out of bed and going to the toilet during the recovery period.

Patients undergoing mandibular osteotomy may have two additional drainage tubes coming out of the intraoral wound to drain blood from the surgical site, reducing the degree of swelling and lessening the chance of infection, and will generally be removed as the drainage volume decreases.

2. Postoperative swelling:

There must be a considerable degree of facial swelling after the operation. Generally speaking, the swelling is significant in the first week, which is not suitable for going out; only around the second week can the swelling be significantly reduced; after the third to fourth weeks, most of the swelling is not obvious in appearance, but it will still feel tight and unnatural, which will continue to improve with time. Resting at home for 1-2 weeks is usually recommended. Do not sleep flat on your back, but keep your head up.

3. Ice compress and warm compress:

Within 5 days after the operation, an ice compress can be applied to the surgical site to reduce the swelling. From the 6th day on, a warm compress can be used to eliminate the swelling. (apply an ice compress and a warm compress for 20 minutes each, and take a rest for 30 minutes, about 5 to 6 times a day.)

4. Oral hygiene care:

The surgical wound is mostly in the mouth, and the infection rate of the wound is high, so the oral hygiene care is very important. After eating food or drink other than water, rinse your mouth with cold boiled water or mouthwash to maintain oral hygiene. Do not use toothpastes that are too irritating when brushing your teeth. Use oral ointment as directed by your doctor.

5. Postoperative diet:

After the surgery when you are ending your fast, try to drink some water. If there is no vomiting, try to drink some cold liquid food, such as juice, milk, etc. The next day, you can gradually eat some soft food without chewing, such as rice porridge, steamed egg, pudding, etc. You are required to have a cold liquid diet or soft diet within 2 weeks after operation.

6. Care of skin wounds:

In addition to the possible cuts to the skin at the corners of the mouth, there may be a dressing on the face after the operation. If not, wash your face regularly. The wound should be taken care of with antibiotic ointment without gauze to cover it. The suture should be removed in the outpatient department about 1 week later.

7. Stitches in the mouth:

The sutures in the mouth will be absorbed by the human body. Generally, the sutures do not need to be removed. After 2-3 weeks, cotton swabs can be used to gently clean the area around the wound to help it fall off naturally.

8. Healthy living habits

Getting out of bed early for activities as your physical strength allows and returning to normal living habits as soon as possible are conducive to the early recovery of physical strength. Postoperative living habits should be normal with plenty of rest.

Facial contouring

Possible complications

1. Postoperative infection:

All operations have a risk of infection. Because the wounds from facial contouring are mostly in the mouth, if the oral hygiene is poor or living habits is unhealthy, the chance of infection will be increased.

2. Cracked corners around the mouth:

Due to intraoral surgery, surgical instruments may cause superficial cuts to the lips and the nearby skin, especially the corners of the mouth, which will heal automatically after 1-2 weeks of treatment with the oral cream.

3. Numbness of gums and dullness of skin:

After the operation, some patients will experience paresthesia, which is temporary. The degree of recovery varies from person to person. It takes about 3-6 months, but it does not affect the facial expression.

4. Internal fixation exposure:

Poor wound healing or infection can expose the nail used for fixation. After the bone heals (6 months after surgery), it will be removed with local surgery.

5. Postoperative acute respiratory distress syndrome:

If the wire between the upper and lower jaws is fixed after the operation, tracheospasm or laryngeal edema will occur easily after extubation under anesthesia. It may be necessary to delay the removal of the endotracheal tube.

6. Avascular necrosis:

It is caused by poor blood circulation or wound infection after osteotomy. The necrotic bone mass may need to be removed or reconstructed.

7. Orthodontics:

After the operation, it is still necessary to cooperate with the treatment and adjustment of the orthodontic appliance by the orthodontist, and follow the doctor's instructions to return to the clinic and take the medicine on schedule.