Mandible gill osteotomy

This surgery involves making an incision inside the mouth and removing the gill bone of the mandible.
The tight gills form the impression of a large, strong face into a clean, well-defined, egg-shaped face.
It makes the face smaller and gives a gentle impression.
In gill shaving, we consider not only the gills but also the entire facial line from the tip of the chin to the gills in a comprehensive manner.

Recommended for this type of person

Those who have gills.
For those who want to have a small face
Those who want to reduce the size of their frontal face
Those who want to smooth out angular facial lines
For those who wish to have an oval contour.

Features of this hospital

1、Pre-operative CT examination, bone modeling
Since the amount of resection may be limited depending on the location of the mastoid nerve canal, we perform a CT scan and create a 3D bone model of the patient before surgery to determine the exact amount of osteotomy and shaving.

2. to create a sharp and ideal facial line
The general method of removing the gills at other clinics is to remove only the angle of the mandible, but this method results in an unnatural finish because only the angle is removed, and there is little change after surgery. In our clinic, we shave not only the mandible but also the outer plate, which protrudes outward, so a significant change can be obtained after the surgery.

At our clinic, we use 3D simulation software "vectra" before the surgery to show you a 3D image of the postoperative result, so you can visualize the postoperative result to some extent before the surgery.

-surgery art of war

An incision is made several centimeters inside the mouth, and excess gill bone is removed using a special instrument along the osteotomy line design.

I. Design
II. Drill a bone hole in the shape of the osteotomy line in advance using a contra-angle.
III. Osteotomy with osteotome is performed
IV. Forms an anatomically normal, curvilinear mandibular angle

-Image of completion Completion image

Before
After

(medical) case

Postoperative course and follow-up

Treatment Time: About 120 minutes

Postoperative hospital visit: Progress check the next day (2 days after surgery)
(Absorbable threads are used, but basically stitches are removed.)
Avoid hot, hard, spicy, and other stimulating foods for 1-2 weeks after surgery.

Postoperative swelling: The swelling will be large for about 3 days and swell for about 1 week. (There is an individual difference)

Tape Fixation Fixation: 3 days

Treatment on the day of counseling: not allowed

anesthesia: General anesthesia, combined with local anesthesia

shower: shower

face-washing: No wetting is allowed on the day of the procedure due to bandage fixation. It is possible from the next day.

Charge

Mandibular gill osteotomy: 1,320,000 yen

Mandibular gill osteotomy + masseter muscle resection: 1,540,000 yen

masseter muscle resection: 440,000 yen

masseter muscle botulinum toxin: JPY107,800

Ella pin removal (plate, screw, wire): 220,000 yen

Osteotomy set (cheek + mussel + gills): 3,300,000

: All prices include tax.

Postoperative risks and side effects

- - - - - - - - - - - - - - - - - - - - - - - Infection (to fester): If there is increased or prolonged heat, pain, or swelling after surgery, infection is suspected. If infection occurs, oral medication, antibiotics, and cleaning are administered.
In severe cases of infection, the skin of the mouth and gills must be cut open to drain the pus.

-Blood Blood pools.: If blood accumulates in the wound after surgery due to bleeding, it will swell to a purple color from the chin to the neck. If the blood is left to accumulate, it can become infected and form a lump, so it must be treated as soon as possible.
If bleeding occurs in the wound after surgery, the blood will pool and swell to a purple color from the chin to the neck. The pooled blood flow can cause infection and lumps. It may be necessary to make an incision in the oral cavity and drain the pooled blood.

-Intraoperative hemorrhage Intraoperative bleeding: Large blood vessels in the jaw may be injured during the surgery, resulting in heavy bleeding. In very rare cases, blood transfusions may be necessary if the bleeding is excessive and anemia is severe.
If the bleeding does not stop, we have no choice but to incise the skin under the chin to stop the bleeding. Please be aware that this will leave a scar under the chin.

-Don't worry. Sagging, excess skin: The skin and muscles shrink to fit the thinning skeleton. The skin rarely droops, but the loss of protruding gills may give the appearance of a flabby contour.

-Paralysis of the lips and jaw Numbness and numbness of the lips and jaw sensation: Surgical manipulation requires touching the area near the sensory nerve. This may cause numbness and tingling in the lips and jaw.
Although it varies from person to person, most cases will take 3 to 12 months to subside.
In rare cases, however, the sensation may not be completely restored.

-Mouth distortion Distortion of the mouth: During surgical manipulation, it is necessary to touch the area near the facial nerve that runs along the lower jaw. This may slow down the movement of the facial muscles and cause the mouth to become distorted.
Although it varies from person to person, in most cases it will take about 6 months to heal. In rare cases, the condition may not completely return to normal.

-David Lack of gill reduction effect: Shaving the gill bone from inside the mouth is a manual operation. Therefore, it is not possible to shave the bone exactly as planned. Sometimes the bone removal is not sufficient. Even if the bone is removed as planned, the contours may not be sufficiently reduced due to the muscle, fat, and skin covering the bone.
When it is confirmed that there is bone remaining that can be removed, we will perform another osteotomy of the gills. Please be aware that the larger the amount of bone removed, the more likely it is to be concave, resulting in an unnatural facial line, and also the more likely it is to cause paralysis. If the cause is the muscles (masseter muscle of the gills) rather than the bones, we recommend Botox injections.

-Left to right difference left-right difference: Shaving the gill bone from inside the mouth is a manual operation, and it is not easy to remove the bone accurately. Therefore, there may be a left-right difference in the size of the removed bone. In addition, there may be a difference in the size of the mandible between the left and right sides. In this case, the left-right difference is likely to remain after the surgery.
If there is a clear difference between the left and right sides of the face, the bone on the side with the larger gills remaining is shaved off and corrected.
If the cause is the muscles (masseter muscle of the gills) rather than the bones, Botox injections are recommended. Please note that even if revision surgery is performed, it may not be possible to achieve perfect symmetry.

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