LONG SIDE
Anterior vertical facial hyperdivergence syndrome is characterized by a particularly elongated lower face. The excessive bone growth in the lower face (mandible) can cause an unsightly face, known as a “long face.” In addition to the aesthetic aspect, this elongated lower face can mainly cause difficulties in chewing (lower and upper jaws that are poorly aligned), an open lip (difficulty closing the mouth), and tension in the face.
A “long face” can therefore pose aesthetic and/or functional problems .
When the surgeon deems it necessary and feasible, the patient can be operated on. This is called an osteotomy (cutting and replacing the bone using small plates and screws). This type of operation is part of orthognathic surgery.
When to have an operation?
Planning
Choosing a time when you can take the time you need to recover is essential. Avoid scheduling surgery before major events or periods of stress.
Availability
Make sure you have enough time available for preoperative consultations, surgery, and recovery. It is essential to follow the surgeon’s recommendations.
Season
Some patients prefer to schedule the operation in winter for practical reasons. Since the scars are inside the mouth and therefore not exposed to the sun, there are no risks in this regard.
Is orthognathic surgery painful?
Pain during the operation: The operation is performed under general anesthesia, so there is no pain for the patient during the operation since he is unconscious.
Postoperative pain: It is normal to experience some pain, pressure, and discomfort, despite pain medication.
Swelling and bruising: Swelling and bruising in the lower face are common. Topical cold can help reduce swelling. You can do this by filling a hot water bottle with ice water.
Sensitivity to touch : The operated area may be sensitive to touch for a while, but this sensitivity decreases as healing progresses.
Before/After Simulations of a long face
How to find a surgeon for maxillofacial surgery?
Recommandations
Talk to friends, family members, or colleagues who have had successful surgery. Their experiences and recommendations can be invaluable.
Avis
Look for online reviews of potential surgeons. However, be critical and consider the diversity of experiences, avoiding relying solely on reviews.
Initial consultation
Schedule consultations with several surgeons to discuss your goals, ask about their experience, and review examples of previous surgery results. This will allow you to assess your relationship with the surgeon and better understand their surgical approaches.
What are the risks of orthognathic surgery?
Bleeding
Excessive bleeding may occur during or after surgery. In most cases, it is controlled during surgery, but postoperative bleeding may require medical intervention.
Infections
Although infections are rare, there is a risk of infection after surgery. Antibiotics may be prescribed to prevent infections, and it is essential to follow all postoperative instructions to reduce this risk.
Anesthetic Reactions
Adverse reactions to anesthesia can occur. However, these reactions are rare and are usually well managed by the medical team.
Bruising and swelling
Bruising (accumulation of blood) and swelling are common side effects after surgery. They can contribute to postoperative discomfort and take time to resolve.
Scarring Problems
Some people may develop obvious scars, especially if they have a genetic predisposition to hypertrophic scarring or if they do not follow post-operative instructions properly.
Altered Sensation
Temporarily, changes in sensation in the face may occur. This may include a feeling of numbness or tingling.
Asymmetry
Despite the surgeon’s efforts to achieve symmetry, there may be slight asymmetry after complete healing.
Aesthetic Dissatisfaction
The final result may not meet the patient’s expectations. Open communication with the surgeon during preoperative consultations is essential to avoid this as much as possible.
What are the steps of long face surgery?
1) Initial consultation
The process begins with a consultation with a qualified surgeon. The patient discusses their aesthetic or functional concerns and expresses their expectations for the surgery. The surgeon examines the patient’s face and teeth and may request an X-ray.
2) Simulation
Computer simulation: A simulation can be performed to simulate the outcome and help the patient visualize the desired result. Perform a simulation.
3) Preparation for the intervention
Medical Examinations: The patient undergoes medical examinations to assess their general health and fitness for surgery. Informed Consent: The patient discusses potential risks and expectations and signs an informed consent form.
4) Day of the intervention
Anesthesia : Before the procedure, the patient is anesthetized.
Incisions : The surgeon makes the necessary incisions in the gums, peels back the gum to access the bone.
Cutting and fixing the bones : The surgeon cuts the bones to be moved, places them at the desired angle and offset (sometimes using a splint) and fixes them using small titanium plates and screws.
Sutures and dressing : Once the adjustments are made, the surgeon closes the incisions with sutures and applies a mouth dressing.
5) Post-operative period
Medical monitoring: The patient is monitored during the postoperative period to ensure that he or she is recovering normally.
Medical prescriptions: Medications, including pain relievers and antibiotics, are often prescribed to manage pain and prevent infections.
6) Follow-up
Consultations: The patient has regular follow-up consultations with the surgeon to assess healing, remove sutures, and monitor progress.
Full Recovery: Full recovery may take several months, and final results may not be apparent immediately due to residual swelling.
What are the benefits of ultrasonic surgery?
Ultrasonic surgery, also known as ultrasonic orthognathic surgery, is a newer approach to surgery. Cutting is performed by vibrating inserts placed in contact with the bone. The micro-vibrations are caused by a piezoelectric machine.
This technique has many advantages:
Structure preservation:
The use of ultrasound allows for a gentler and more precise approach, which can allow for the preservation of soft structures (skin, veins, nerves, etc.). This is particularly advantageous for minimizing trauma to surrounding tissues.
Less bleeding:
Ultrasonic instruments can help reduce bleeding during surgery compared to other methods. This can contribute to faster recovery and less postoperative bruising.
More precise carving:
Cutting the bone with a piezoelectric device allows for more precise cutting.
Less invasive technique:
This method is often considered less invasive compared to some traditional techniques (burrs), which can result in faster recovery and reduced post-operative edema.
Before/After Simulations of a long face