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Protrusion Mandible Reduction Plastic Surgery

Homepage Star of September 2011
[ Author:Fushun Ma | Time:2011-10-22 16:37:01 |  Font Size: [Large Medium Small]
Tags: mandible protrusion, ssro, underbite, misbite, jaw protrusion, big jaw

Mandible protrusion also know as underbite or misbite. It is one of the malocclusion deformities of the upper and lower teeth. For those with minor mandible protrusion the dental occlusion is abnormal, but no facial deformity or abnormality can be noticed. For severe mandible protrusion sufferers the lower incisors could be few centimeters ahead of the upper incisors with obvious facial deformity combined with chow and speech function interference, even symptoms of Temporomandible Disorders may exist. Though few mandible protrusion sufferers do have their maxilla bone underdeveloped the vast majority of the protrusion facial appearance are caused by the overgrowth of the mandible bone before puberty and the end result for that overgrowth at adulthood is a big mandible bone and anterior positioned lower incisors.

For minor mandible protrusion a orthodontic process may be good enough for improving the facial figure. For severe mandible protrusion only a mandible reduction surgery could restore the normal occlusion and thus the facial appearance. The most frequently used surgery for correction of a protrusion mandible is Sagittal Split Ramus Osteotomy, also known as SSRO, mandible reduction surgery. Other surgeries such as mandible angle wedged ostectomy and mandible body ostectomy may also be applied according to the pattern of the deformity or the surgeon's preference. The boy in the pictures on this page has a remarkable mandible protrusion. His lower incisors located more than 2 CM in front of the upper incisors. He underwent sagittal split mandible reduction surgery end up with a satisfactory outcome.

mandible protrusion surgery photos
Before surgery the length of his chin is big and the chin is deviated to the left side. The over protruded mandible bone stretches the lower jaw skin making the lower lip inverted. After surgery these problems are not exist any more.

profile photos of protrusion reduction surgery
A profile view mostly reveals the characteristic facial pattern of a mandible protrusion person. As we can see from the pictures before surgery the lower jaw is longer than the upper jaw and the lower lip is in front of the upper lip. A sagittal split mandible reduction surgery changed this boy's facial contour back to normal.

protrusion surgery before and after surgery photos
Originally this boy's lower jaw line is too long making the facial shape long and narrow. The surgery reduced the length of the mandible and the face looks normal.

CT image of protruding mandible
CT image of mandible protrusion. The mandible bone is long from overgrowth. The chin is protruded to the front as show by the red arrow.

Background Story

This boy is tall and he didn't talk much to Dr. Fushun Ma at consultation. He didn't ask much question before he and his family decided to go ahead to do the operation. He went through all the preparation processes such as CT image study, plaster teeth model and lab work and finally toke the operation. His surgery went eventless and he recovered smoothly and fast. All the post surgery photos was taken at the next day after his operation when the bandage was removed. Even though at this early post operative stage   his lower face was swelling especially in the area over the mandible angle, his lower jaw is not protruding anymore. When he saw his face the first time after surgery he was happy with the changes. Dr. Ma believes that when the swelling subsides he will be happier with his result. At the time of compose this page more than a year has passed since his surgery. Dr. Fushun Ma still didn't get any news from him even he was told to see Dr. Ma for follow up 6 months post surgery.

Photo Analysis of Mandible Protrusion Reduction Surgery

Post operatively in the front view the face is not crooked and the dimension of different parts of the face is more balanced. The height of the chin is short and the lower lip is not inverted. The upper lip seemed longer after surgery  giving a better looking mouth. The chin is not as deviated to the right side as before the surgery and the skin of the lower jaw is not as tight as before the surgery making the facial expression natural and free.

A profile view can mostly reveal the characteristic facial pattern of a mandible protrusion person. As we can see from the pictures before surgery the lower jaw is unproportionally longer to the rest of the face, even hiding the upper face in someway. Or the upper face seemed embedded into the lower jaw. The lower lip is in the front of the upper lip and there is a obvious step between the upper and lower lips.

At the first glance of this boy's face we might believe that his upper jaw is at least retrograded from underdevelopment during his growth phase. At the time when Dr. Ma newly started his care as a maxillofacial surgeon Dr. Ma's suggestion to this kind of patient often includes a maxilla bone sliding forward or maxilla bone distraction surgery combined with a mandible reduction surgery to maximize the restoration effect. After many years practice and the use of CT facial skeleton analysis Dr. Ma realized that most of the mandible protruding person have only lower jaw overgrowth with a normal sized, not underdeveloped upper jaw. So mandible reduction surgery alone could achieve a good restoration result. Thus the surgery trauma and the finance burden of the patient could be greatly relieved. Just like this boy it seems his upper jaw is underdeveloped if you just see the pre-surgery profile photo but only a mandible reduction surgery was need to made his face contour going back to an ideal shape.

Oblique view, the overgrowth mandible makes an excessive long mandibular line. The face at this angle looks slim and long. The big mandible overwhelms the maxilla bone, even at smile the upper teeth will not show at the before surgery photo. After the mandible bone has been reduced the upper teeth can be easily show at smile. This group of picture also show that not only the chin is set back, the height of the chin is getting short, so the length of the whole face is short. This changes make the length to width ratio of the face toward normal and the face looks more natural.

Mandible protrusion reduction surgery could restore the facial contour instantly. However the chow function of the teeth needs some time to adjust as the relationship of the upper and lower teeth changed with the backward movement of the whole set of the lower teeth and the mandible bone. Before surgery the upper and lower teeth is in a malocclusion relationship yet chow function is sound as a result of many years adjustment. The chow function interference caused by mandible reduction is due to the mismatch of the contact surface of the teeth after the reduction surgery. It again is adjustable with time. This kind of adjustment could take years. It is very rare to have a post mandible reduction patient who needs a orthodontic process because of failed chow function adjustment.

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