ICD-9-CM 76.61-76.64 | ||
Jaw reduction is a type of surgery in which the objective of treatment is to narrow the lower one-third of the face—particularly the contribution from the mandible and its muscular attachments. There are several techniques for treatment—including surgical and non surgical methods.
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Facial aesthetics
A square lower jaw is generally considered a very masculine trait. Widening of the lower third of the face can cause either a square appearance to the face as a whole or can distort the natural appearance of the angle between the chin and the neck.
Whereas square lower jaws are often considered a positive trait in men, a wide mandible can cause significant facial discordance and/or masculinization of the female face. Even in certain men, the size of the lower jaw can cause facial disharmony—particularly when there is asymmetry.
A wide lower face can primarily be caused by enlargement of the mandible or masseter muscle.
Causes
The primary cause of an enlarged mandible is developmental or congenital. There are some rare disorders that can further widen the jaw such as acromegaly.
Conversely, while a masseter muscle can be large due to congenital reasons, it can commonly be an acquired deformity. Like any muscle it increases in size with exercise. Behaviors such as repeated gum chewing, teeth clenching, or bruxism can contribute to enlargement of the muscle.
Techniques
There are several jaw reduction techniques available—both surgical and non-surgical. Ideally prior to selection of a treatment, the patient is examined to determine whether the cause is due to the bone, the masseter or both. Additionally, if a treatable cause is present it should be identified.
Botox injection
Non-surgical techniques are essentially limited to cases in which the masseter is enlarged. A convenient method to treat an enlarged muscle is through the use of botox injections. Botox is injected into the enlarged muscle, weakening it so it slowly becomes smaller through atrophy over several months. There is no down-time and improvement is gradual—individuals who interact with the patient may never know that a plastic surgical procedure was performed
The use of Botox for jaw reduction has been studied scientifically. Improvement is generally not seen for at least 2 – 3 weeks. Peak improvement occurs at months 3 to 9 with good results still observable at one year in many patients.
The procedure can result in temporary paralysis of the muscles that move the lips, a rare, but danger acknowledged complication.
Surgical reduction
Surgical techniques are used to directly reduce the size of an enlarged mandible. Incision can be to the inside or outside of the mouth, though the internal incision is the most common because it leave no visible scar but unsafe. A burr is used to remove the outer layer of the enlarged mandible, narrowing the jaw.
Potential complications include injury to the inferior alveolar nerve which provides permanent numbness that unable to undo and it leads to damage to lower lip and even death.