mandibular mussel osteotomy

The mandible is a very important part in determining facial impression.
Long jowls, squat jowls, too small jowls, and other jowls can cause a variety of problems, which in turn change the impression of the jowls.
A well-defined jawline balances the entire face, giving it a more elegant and beautiful appearance.

Recommended for this type of person

Those who are concerned about the length of their jaw.
Those with a forward chin
Those who wish to have a face line.
Those who want to make their faces smaller
Those who wish to have their chin forward.

Features of this hospital

Preoperative CT scan and bone modeling
Since the amount of resection may be limited depending on the location of the miter nerve canal, we perform a CT scan and create a 3D bone model of the patient prior to surgery to determine the exact amount of osteotomy and shaving to be performed.

2. to create a sharp and ideal facial line
In order to achieve a smooth and well-defined facial line, we also smooth the borders of the osteotomized area to eliminate bumps and provide a comprehensive facial line from the gills to the tip of the chin, so that significant postoperative changes can be achieved.

An incision is made in the gum area of the mouth, and depending on the design, osteotomy or shaving is performed to shape the jaw.
Surgeries include ottogai shaving, ottogai osteotomy, ottogai mesorrhaphy, ottogai mesorrhaphy plus anterior shift, and T-osteotomy.
Careful design discussions are held based on 3D simulations and CT images,
By matching the image with the patient and performing the surgery with precision, the desired impression can be achieved.

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

Osteotomy and osteotomy

Pattern 1
Cut or shave the bone
Pattern 2
Cut or shave the bone
Pattern 3-1
Cut or shave the bone
Pattern 3-2
We move the bone and fix it with a plate.

Osteotomy (de-intercalation)

I. Design the incision line
II. Bone resection.
III. Move the bone and remove the step.
IV. Fixing with a plate

Osteotomy (midline removal) + forward movement

I. Design the incision line
II. Separate or remove bone
III. Move the bone and remove the step.
IV. Fixing with a plate

Maternal T-osteotomy (V-line formation)

I. Design the incision line
II. Separate or remove bone
III. Move the bone and remove the step.
IV. Fixing with a plate

Osteotomy (mid-section) + T-joint osteotomy

I. Design the incision line
II. Separate or remove bone
III. Move the bone and remove the step.
IV. Fixing with a plate

(medical) case

-Maxillary mussel osteotomy Mandibular mussel osteotomy

Upper: before surgery Lower: 2 months later
Upper: before surgery Lower: 2 months later
Upper: before surgery Lower: 2 months later
Upper: before surgery Lower: 2 months later

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: 3 days

Treatment on the day of counseling: not allowed

anesthesia: General anesthesia, combined with local anesthesia

shower: Available from the next day

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

Charge

Osteogenesis ossificans (bone removal from the skull): 660,000 yen

ostracism: 880,000 yen

Osteotomy (de-intercalation): 1,100,000

Osteotomy (midline removal) + forward movement: 1,320,000 yen

Maternal T-osteotomy (V-line formation): 1,430,000 yen

Ottogai T-osteotomy + forward movement: 1,530,000

Osteotomy (mid-section) + T-joint osteotomy: 1,540,000 yen

Maternal 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.

-Philadelphia News Less effective: There is a limit to the size of the jaw bone that can be cut out, as it is limited to the area below the nerve line. If we feel that we do not have enough bone to remove, we will take another x-ray to determine if revision surgery is possible, and if there is room to remove more bone, we will perform the revision surgery. Please note that the more bone that is removed, the closer it is to the nerve and the more likely it is to cause numbness.

-Left to right difference left-right difference: If the size of the bone cut out of the middle is not the same on both sides, or if the fixed bone is misaligned in the midline, there will be a left-right difference in the contour of the jaw.
It is not uncommon for the lower jaw and gill bones to originally have a left-right difference. In such cases, the left-right difference is likely to remain after surgery. Not only the bone, but also the shape and thickness of the flesh can differ from side to side.
The left-right difference in the contour of the jaw is caused by the amount of bone removed, the position of fixation, the original left-right difference, and the left-right difference in the shape and thickness of the flesh. If there is a clear difference between the left and right sides, we will adjust the bone removal and fixation position as much as possible. Please note, however, that even with corrective surgery, it is not always possible to achieve complete symmetry.

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