1. What is Jaw Augmentation?

Also known as mandibular augmentation is the use of synthetics or biologicals to augment, or make the jaw bone structure of the face more prominent. It can give balance to an otherwise less defined face or further augment an already existent mandibular structure.

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2. When can Jaw Augmentation be performed?

Usually anywhere from 18 on up.

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3. What does a typical Jaw Augmentation consultation entail?

After checking a surgeon's background and credentials, you will make an appointment for a consultation.  You will meet with this surgeon and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take. This is very important. 

Visit the Medication & Supplement List for more information. Your skin will be examined and the elasticity will be determined. You will discuss your complaints and concerns and discuss the various techniques and implants available to you.  Your surgeon will explain the technique and incision placement methods that may be most appropriate for you.  The surgeon should discuss the Risks associated with jaw augmentation with you. 

Do not let the surgeon tell you that there are only one or two implants available. This surgery is not a one size fits all type of thing. Knowledge is power - so research before your consultation. There are quite a few types, sizes and models, etc. (although not near as many as malar implants) The above list is only a few of the most popular brands and products.

You will also discuss the available anesthesia that will be used for your procedure. Most Jaw Augmentation procedures are performed under Light Sleep Sedation although some surgeons may use General Anesthesia. Either way, discuss this beforehand. If you do go under General, you make sure that the anesthesiologist is certified.  Please read the All About Anesthesia Page.

If you would like more information on consultations or a list of questions to ask your surgeon please visit the Consultation Help Page.  If you should choose to book or reserve a surgery date you will usually give a deposit to hold your surgery date.  Most times if you cancel a few days beforehand, this amount is non-refundable.  After paying your deposit and scheduling a surgery date, you will also schedule a pre-operative appointment

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4. How is Jaw Augmentation performed?

Depending upon the amount of augmentation and the technique and implant used, Jaw augmentation can last about 1 and 1/2 hours to 2 hours or more if reconstruction is needed. 

You will then be marked with a magic marker type pen which helps the surgeon determine the placement areas. . You will then be scrubbed with Betadine, the surgical marker markings will remain - although not as dark.  You will be injected with a solution of Lidocaine, epinephrine and saline.  The epinephrine is a vasoconstrictor.  This will impede your skin's ability to bleed excessively.

The incision will be made in the predetermined placement, the implant situated directly on top of the bone (or right on top the overlying tissue covering it and either sutured or screwed into place. It may take several tries as the implant is usually customized to your facial structure for comfort and aesthetics. 

The surgical team then performs a sponge and instrument count and your surgeon then closes your incision with, more than likely, a non-dissolvable type suture. Sometimes percutaneous sutures are used but only very rarely with jaw augmentation.  This is normally reserved for malar implants.  This is where the sutures stick partially out of the skin and can be removed later on by tugging gently on them after they have partially dissolved within.  They can also be sutured with dissolvable stitches inside the surrounding tissues.  Even still, they may not be sutured at all, relying on your body's collagen to secure into place.   If no internal sutures are used you will more than likely wear your tape or a head wrapping longer unless the pocket specifically fits your implant snugly.  This wrapping will be worn post-operatively during the day for the recovery period and is worn at night to help it heal properly in the face per your surgeon's instructions.   If you are not familiar with this "look" it involves wrapping a dressing around the top of your head to underneath your jaw, sometimes slightly over your ears.  Of course there may be differences in surgical technique depending upon the preference of your surgeon.

You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released.  This is dependent upon the individual but may take up to two hours.  Your face may feel tight and quite tender as the anesthesia wears off. You may even feel emotional or upset - this will depend upon your body's reaction to anesthesia.  You may also experience "rigors" or shivering.  This may feel uncontrollable and  is usually from the medications - more than likely epinephrine that is used as a vasoconstrictor.  The recovery nurse usually has wrapped you in a warm blanket but if not, request one.  It certainly makes things more tolerable.  You may even be fortunate to have heating lamps.

Some patients feel nothing different although if you have had General you may feel a little sick - hopefully your surgeon gave you something to lessen this.  Your prescribed medication should alleviate this pain and discomfort.  However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately.  You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home.

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5. What should I expect post-operatively? 

You may be groggy from the anesthetic and/or oral medications and probably won't remember much of the first day or two.  You will have to take it easy and sleep on two pillows to keep your head elevated for 7-14 days - or however long your surgeon suggests.  When you wake up you will notice that your face will look even more swollen in the first 3 days.  But, as the days go on the swelling will dissipate.  There may be bruising, but this will go away, as well.  So make a mental note of this or you may be shocked into a depression.  Bruising and swelling are a normal occurrence in most surgeries.

You will more than likely experience some discomfort for several weeks - having had intraoral incisions your diet may be restricted.  You should make certain all fresh fruits and vegetables have been washed, no raw fish (sushi), very rare meat or other types of foods that may contain high amounts of bacteria.  Eating foods such as this may increase your risk of infection due to the incisions being in the mouth.  You may be instructed to rinse with Listerine several times a day.  DO NOT PICK or "tongue" your incisions or sutures!

Although any discomfort should be alleviated by your prescribed pain medication if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon immediately!  Take your temperature regularly.  An elevated temperature could mean an infection.  Take those antibiotics on time. Also, don't forget if you are a female taking birth control pills that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well.

Even though you may feel better, you must take it easy for the first 3 weeks.  Be careful not to bend over or lift heavy objects.  And be careful not to raise the blood pressure for at least 3 weeks as this could cause internal bleeding at your treatment area.  Your blood vessels dilate to allow increased blood flow when you raise your heart rate.  This may cause problems at internal wound sites.   Do not participate in contact sports for at least 6-8 weeks - although ask your surgeon what he recommends specifically.

You may notice a change in your smile, odd sensations of "tightness", tingling, the sporadic sharp pain, or "pulling", burning, and cold sensations.  These usually subside within the first few weeks but the remainder of the swelling will take months to dissipate.  Just know that your swelling will subside, revealing a more defined jaw structure and a more youthful, proportionate you. Although this may take some time so please prepare yourself emotionally.  Some patients experience a "lull" or down period where they become depressed or feel unattractive.  This is very normal.  Please print out our Emotional Preparation Sheet so that you will be able to remind yourself that you will get through your low period.

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6. When will the stitches be removed and does this hurt? 

If you had non-dissolvable sutures, these will more than likely be taken out by your surgeon at a week to 10 days postoperatively.   If you had dissolvable sutures, this will dissolve in about 10 days. 

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7. When will I be able to see the results?

The results are immediate, in fact you may believe that you have received too much augmentation and demand that your jaw implants be taken out.  This is a common emotion and you must wait until you are fully healed to determine if you dislike your new jaw line.  There is significant swelling with jaw augmentation so please be advised of this fact.  Just know that your swelling will subside, revealing a more defined jaw structure and a more youthful, proportionate you. Although this may take some time so please prepare yourself emotionally.  Some patients experience a "lull" or down period where they become depressed or feel unattractive.  This is very normal.  Please print out our Emotional Preparation Sheet so that you will be able to remind yourself that you will get through your low period.

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8. What are the risks of Jaw Augmentation?

Unfortunately, All surgery as risks and complications. With jaw augmentation, these include allergic reaction to the anesthetic used, please see the Introduction to Anesthesia section for more information. You may also develop an infection (the implant must be removed for 3 months, you must take your antibiotics diligently and then and only then can you have a secondary surgery. There could be asymmetry, malposition, dissatisfaction, hematoma or seroma. There is also the risk of "shifting".  If this happens a second surgery may be needed to reposition the implant. 

Also, to ease your fears...there is no conclusive evidence with autoimmune disorders regarding silicone toxicity, rheumatoid arthritis and the like. Solid silicone facial implants have been used for decades in cosmetic applications without any ill effects.

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9. What is Arnica montana or Bromelain, I have heard that these homeopathics reduce swelling and bruising? Which is the best kind to take?

Arnica montana
also known as: Mountain Tobacco, Mountain Arnica, Common Arnica, Leopard's Bane and Sneezewort
plant family: Asteraceae 
type: Herbaceous perennial
parts used: Roots and flowers
description: Arnica montana or Leopard's Bane is a perennial herb, growing close to the ground. The leaves form a flat rosette, from the center of which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers. The rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry rootlets on the under surface.
habitat: Indigenous to Central Europe, in woods and mountain pastures, although it has been found in England and Southern Scotland. 
warning: This herb should NEVER be taken in raw form. This plant, like many medicinal plants if ingested, can cause intestinal bleeding, abdominal cramping and sickness. Homeopathy is the medicinal use of tinctures and suspensions using herbs and other plants and should never be consumed without proper preparation. Only respectable homeopathic remedies and tinctures should be consumed. 

Arnica montana has been used in Europe for centuries to treat swelling, soreness and bruising.  This product is often misunderstood when confused with ingesting the arnica plant in its raw form. When properly prepared, Arnica may significantly decrease the healing time or the appearance of such.  There are many formulations from different companies. Sublingual (under the tongue) types are the most often recommended for plastic surgery.  

habitat: Indigenous to southern Brazil and Paraguay, The fruit is now grown all over in green houses and in the fields of Spain, Guatemala, Hawaii and more. The pineapple is a tropical plant and thrives in hot, humid places. Although it can survive cold snaps, it is not recommended for the more northern areas if intended to be grown outdoors.

Bromelain is an anti-inflammatory formula containing the proteolytic enzyme from the stems of pineapples. Proteolytic enzymes are capable of dissolving proteins. It is most often used after sports injuries, to relive edema and after surgical procedures to help with swelling. 

ALWAYS ASK YOUR SURGEON FIRST BEFORE TAKING ANY MEDICATION.

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 10. Are the results permanent?

Yes, jaw augmentation is permanent unless an unforeseen problem (such as infection or extrusion) arises creating the need for removal. 

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This page was last updated: 08/24/2005