Orthognathic surgery: complications and reviews
Modern medicine offers ample opportunities to eliminate or correct annoying natural anomalies of the maxillofacial area. Sometimes, only a small correction with the help of orthodontological devices - braces, cap, etc., is needed to get the desired result. But often the matter is much more serious, and it's not just about cosmetic problems, but also about the violation of the most important functions of the body - chewing, breathing, diction. In such cases, the patient is recommended orthognathic surgery.
Surgical intervention of this kind involves correcting the shape, size, position and ratio of the upper and lower jaws. This plastic provides a significant correction of the bite, as well as restoring the proportions of the face. For many, orthognathic surgery becomes the only chance to make life easier and to have a pleasant appearance.
The procedure is included in the section of maxillofacial and plastic surgery, fifteen years ago this treatment was prescribed only when anomalies in the structure of the skeleton disturbed a person in everyday life: the function of chewing, speaking, etc. was disrupted. Today,aesthetic surgery, when orthognathic surgery and rhinoplasty jointly remove facial defects that prevent a person from leading a full life.
In general, orthodontology and orthognathic treatment are designed to perform similar tasks, but in the latter case there are more opportunities to eliminate serious problems when it comes to changing the position of the bones.
Orthognathic surgery is a complete surgical intervention, so it is not recommended for every patient. Only after a thorough examination and diagnosis is possible to say with certainty about the conduct of such treatment. Contraindications can be the patient's age, unprepared dentition, serious diseases, such as heart disease, diabetes, acute infection, etc.
Indications for operation
Incorrect position of the upper and lower jaws, bite anomalies can be both congenital and acquired, that is, consequencesinjuries or an incorrect operation. During the growing up of a person, all these problems begin to have a detrimental effect on his psyche, leading to the development of a variety of complexes. In order not to bring things to a state of neglect, people with similar anomalies must have an orthognathic operation. The patients' comments, as well as numerous photos with the result, confirm the positive results of such surgery.
Treatment involves a comprehensive approach and begins with an examination by an orthodontist, if the problems of the maxillofacial system can not be corrected by correction with the help of braces, then the joint work of the orthodontist and a specialist in orthognathic surgery is already underway. The indications for surgery can be the following reasons.
- aspect ratio asymmetry;
- open bite;
- gingival smile;
- strongly protruding lower jaw;
- chin chin.
- problems with chewing food;
- breathing disorder;
- various speech defects;
- chronic pathology of the temporomandibular joint.
Treatment involves several stages, where the longest is preparation for surgery, it can take a year or more. Surgical intervention is possible only after the patient reaches the age of 18, when the process of bone growth has already stopped, the ideal age is 20 or 30 years. The reason for the refusal of the operation can be individual characteristics of a person - an allergy, a reaction to anesthesia or intolerance of certain drugs.
Advantages: the opinion of patients
The frightening word "operation" is the solution to a large list of problems that can only be removed surgically. The treatment has the following advantages, according to the patients:
- A person has confidence in his appearance, and therefore in himself.
- As a result, self-esteem rises, before and after pictures best describe those cardinal changes that occur with the patient.
- An incorrect bite or misalignment relative to each other causes not only aesthetic discomfort, but also affects important body functions;a man chews and receives a permanent upset stomach, spoiled diction, there are difficulties in breathing;Orthognathic surgery allows you to get rid of such problems.
In addition, the results of treatment, according to people, with a few exceptions are well preserved for a long time. But, as in any procedure, there are also disadvantages here. For example, the fact that the preparatory period, the operation itself and rehabilitation are a complex process, hardly tolerated by a person. In addition, many people are stopped by the high cost of treatment and the duration of all actions.
A patient who has decided to perform a surgical procedure to correct anomalies of the maxillofacial system should be prepared for the duration and complexity of such treatment. Doctors always work in a complex, especially if changes of a cosmetic nature are forthcoming, in this case it is necessary to immediately connect a plastic surgeon, so that after the main operation, the nose, lips and other soft tissues should be corrected. The preparatory stage includes the following actions:
- Monitoring oral problems and their elimination, at this stage the dentist can remove plaque, carry out complex dental treatment, extract unnecessary roots, etc.
- The second preparatory period implies orthodontic treatment. Experts jointly develop a model of actions and draw up a work plan, which needs to be carried out with the help of braces. This stage can last from several months to one and a half years, all depends on the complexity of the existing anomaly and the scale of correction.
- Only after orthodontic treatment the patient passes into the surgeon's group, where he has to undergo various kinds of diagnostics.
- Casting of jaws;Using a computer program, 3D modeling of the initial and final result occurs;profilometry;X-ray examination;anthropometry of the face.
If necessary, the surgeon can prescribe additional examinations, as well as involve specialists from other areas.
Immediately before the operation, doctors recommend not to eat or drink anything for twelve hours, if the patient is taking any medications or if he feels slight malaise, it is necessary to notify the surgeon about it.
Types of operation
Such a surgical intervention involves a combination of several techniques and is quite a complex and responsible operation. Depending on the specifics of this or that case, it can last from one to six hours. All cuts the doctor makes inside the oral cavity, so that there is no external scars.
After all the diagnostics and analyzes, compiling a computer model of the patient's jaw, an orthognathic operation is performed. How it is done depends on the type of violation and how it is eliminated:
- Orthognathic surgery on the upper jaw implies the following manipulations: through the holes behind the eye sockets the surgeon moves the bone system, the sky and teeth including in the right direction and fixes them with a special tire.
- Mandibular osteotomy - here a cut is made behind the molars, the jaw is set in the desired position, which is fixed with titanium plates. After the growth of bone tissue plates are removed.
- Aesthetic orthognathic surgery is about cosmetic correction of the deficiencies of the maxillofacial system. Here there is a correction of the symmetry of the face due to the correct installation of the chin.
- Segmental osteotomy, when the bite is normalized by moving one or more teeth.
In some cases, for fixing the jaw in the required position, arcs for orthognathic surgery may be needed, in complicated cases they are used in the preparatory stage. Usually patients spend 2-3 days in a hospital and if there are no complications, no less significant stage of treatment comes - rehabilitation.
As with any surgical intervention, a person may experience pain, discomfort, the face may appear edematous, there is also a slight weight loss, nausea, nasal congestion and numbness, the emergence of all these effects depends on individual characteristics, they usually passwithin 15-20 days.
After the orthognathic operation is performed, the person still has a whole complex of measures to prevent complications and to fix the result. The next day the patient is prescribed a course of antibiotics, and an elastic bandage is applied to the problem zone, which is removed after a day.
The most unpleasant moment for the patient is the forced need to wear special rubber bands that are located between the teeth. With them, one should not open his mouth wide, chew and blow his nose. Postoperative sutures are usually removed after 10-14 days, and after another three months, internal bolts from the gums are removed.
All the rest of the healing process, after an orthognathic operation, on the conscience of the person himself. The doctor is obliged to instruct the patient about how to eat, brush your teeth, and other nuances of rehabilitation. For a while you will have to give up physical exertion, do not take vitamins and some medicines.
Do not expect a quick result, to detect a noticeable difference, it takes several days or months after the orthognathic operation was performed. The photos before and after will show the desired appearance only when all the edemas come down, and the bones finally rise into their new position.
Possible complications of
As in any section of surgery, there are several unpleasant consequences, which can lead to orthognathic surgery. Complications are extremely rare, but still patients should have an idea about them:
- , a nerve rupture in the lower jaw is possible;
- damage to the facial nerve, which can cause numbness in the lips;
- in some cases, scars are formed, but usually they are easily removed with special creams;
- unprofessionalism of the doctor can lead to damage to the teeth, in which case only one exit is possible - restoration;
- infraorbital nerve damage;
- blood loss during surgery;
- may temporarily cause deformation and asymmetry;
- with insufficient disinfection of the oral cavity causes inflammation;
- fracture of the jaw.
All these cases are a rare exception than the rule. Usually, surgeons who perform such operations are highly qualified specialists, who do not allow negligence or accidents. Already thousands of people in Russia have learned what an orthognathic operation is. The patients' reviews are almost always positive and thankful, because the doctor, in fact, gave the person a new life.
The best clinics of
Just a few years ago, the only thing scared the Russians about the possibility of surgical correction of the maxillofacial system. In our country, more recently a culture of maintaining beauty and health began to form, the need arose to look good and presentable. Today, there are already hundreds of clinics offering similar services, you can make the procedure in public hospitals.
So, in Moscow on Volokolamsk highway for many years now operates the Federal Scientific Center of Otorhinolaryngology of FMBA of Russia, where the best specialists in this field work. The team of highly qualified doctors not only conducts operations and appropriate treatment, but actively implements world technologies and develops its own.
In addition, in the capital and in every region of the country there are dozens of private clinics, whose services include orthognathic surgery. Feedback from former and current patients will be able to significantly help with the final choice. The decision should be taken after a personal visit, treatment is long, and a specialist change is undesirable.
Orthognathic surgery before and after it causes a lot of questions, answers to which can not be fully received. Each case is unique, all the nuances of treatment can be announced only by direct treatment.
It is almost impossible to make exact calculations of orthognathic treatment. The whole process involves several important, sometimes long stages, as well as the involvement of specialists from different fields, so that the patient must be prepared for very large expenses. Even in public clinics, you will have to purchase braces, arcs, special bolts and other equipment.
The cost of the operation varies from 100 thousand to 200 thousand, depending on the complexity of the operation. Orthodontic treatment, which precedes the surgical correction, will also depend on the degree of necessary correction of the teeth. Despite the complexity and cost of the process, such operations are quite in demand in Russia, because the result is both this expectation and the money spent.