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Augmentation, mandibular body or angle; prosthetic material

CPT4 code

Name of the Procedure:

Augmentation, mandibular body or angle; prosthetic material
Common names: Mandibular augmentation, jaw augmentation

Summary

Mandibular augmentation involves the surgical enhancement of the lower jaw (mandible) using prosthetic materials to improve or restore facial aesthetics and function. This procedure enlarges or reshapes the mandibular body or angle to provide a more balanced and proportionate appearance.

Purpose

The procedure addresses conditions such as mandibular hypoplasia (underdeveloped jaw), trauma, congenital defects, or asymmetry. The goals include enhancing jawline definition, balancing facial proportions, and improving the patient's overall appearance and functional abilities like chewing and speaking.

Indications

  • Underdeveloped or small jaw
  • Facial asymmetry
  • Congenital defects affecting the jaw
  • Jaw deformities due to trauma
  • Desire for aesthetic improvement in jawline contour

Preparation

  • Fasting for at least 6-8 hours prior to the procedure.
  • Adjustments to medications, especially blood thinners.
  • Pre-operative imaging studies such as X-rays or CT scans to plan the augmentation.
  • Comprehensive health evaluation to ensure suitability for surgery.

Procedure Description

  1. Anesthesia: The patient is commonly under general anesthesia.
  2. Incision: A small incision is made either inside the mouth or under the chin to access the jawbone.
  3. Pocket Creation: A pocket is created in the mandible area where the prosthetic material will be placed.
  4. Insertion: The prosthetic material is carefully inserted and positioned to achieve the desired augmentation.
  5. Securing: The implant is secured in place, sometimes with screws or other fixation devices.
  6. Closure: The incision is sutured closed, and sterilized to prevent infection.

Duration

The procedure typically takes about 1-2 hours, depending on the extent of augmentation required.

Setting

Mandibular augmentation is generally performed in a hospital or outpatient surgical center.

Personnel

  • Plastic or maxillofacial surgeon
  • Anesthesiologist
  • Surgical nurse
  • Operating room technician

Risks and Complications

  • Infection
  • Implant displacement or rejection
  • Nerve damage causing numbness or loss of sensation
  • Bleeding or hematoma
  • Scarring
  • Asymmetry or unsatisfactory results requiring revision surgery

Benefits

  • Improved facial aesthetics and symmetry.
  • Enhanced jawline contour and definition.
  • Increased self-esteem and confidence.
  • Potential improvement in functional abilities like chewing and speaking.

Recovery

  • Initial swelling and discomfort managed with prescribed pain medication.
  • A soft or liquid diet for the first few days to minimize strain on the jaw.
  • Avoidance of strenuous activities for several weeks.
  • Follow-up appointments to monitor healing and ensure the implant remains properly positioned.
  • Full recovery and final results typically visible in 1-2 months.

Alternatives

  • Dermal fillers for temporary enhancement.
  • Fat grafting for moderate augmentation.
  • Orthognathic surgery for severe deformities or functional issues.
  • Each alternative varies in terms of invasiveness, recovery time, longevity, and cost.

Patient Experience

The patient may experience some discomfort, swelling, and bruising post-procedure, which are managed through prescribed pain relief and anti-inflammatory medications. Adequate rest, diet modifications, and follow-up care are crucial for a smooth recovery.

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