Following my orthodontics treatment, I will have mandibular advancement surgery. But as you can see from the pictures, I also need a mid-face lift. I got different opinions from different surgeons regarding the order of the operations.I'm really confused.
Which to Do First - Mandibular Advancement or Midface Lift?
Doctor Answers (10)
Mandibular Osteotomy Should be Done Before Any Midface Lifting
It is not clear from your photos that you really need a midface lift but the shortness of the lower jaw is quite evident. Because that deformity is more obvious and the benefits both cosmetic and functional are quite clear, you should do the mandibular advancement first. Once that is complete you will be in a better position to judge the cosmetic needs of your midface.
Best Order of Having Facial and Jaw Surgery
Mandibular advancement or mid face lift.
I would recommend that you proceed with the facial skeleton and bone work prior to considering soft tissue work.
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Perhaps your mandibular advancement should be done with your orthodontics
There are several different ways to advance the mandible. In your case it looks like you have an overbite and might have the type of mandibular osteotomy that also brings the teeth forward and not only advances the chin??
Regarding the mid-face lift - that decision should be made after the mandibular surgery is completed and has matured.
Order of Surgery - Mandibular Advancement and Midface Lift
I would recommend to have the boney framework surgery done first. This procedure will re-allign the facial balance permanently. Wait for the healing to be near-complete (3-6 months) and reassess your facial aesthetics at that point.
To be quite honest, when I look at your photos, I am not so sure that a midface lift is a true "need" for best aesthetics. Establish the appearance you want to achieve and investigate then, how to get there (rather then zooming into a particular surgical procedure). But wait until after the advancement surgery.
Midface lift or mandibular surgery
It really depends on what you want. You may not need mandibular surgery if your goals are to improve your nasolabial folds. Fat injections may be the better option.
Order of mandibular advancement with facial surgery
Well, looking at the pic, you don't seem to need jaw advancement. But, if for whatever reason you should get the surgery, I would do the mandibular advancement first prior to any soft-tissue surgery. All the best, Dr. Vartanian.
Mandibular Advancement before Midface Lift
It is better to do the underlying skeletal work before changing the skin/muscle covering. You can determine the need for the midface lift after changing facial proportions with mandibular advancement.
Bony surgery before Midface lift
Your mandibular advancement should be performed prior to any soft tissue procedures on your face. The advancement will influence the soft tissue i a positive way and may change you and your surgeon's plan.
Timing of facial cosmetic surgery
I don't think it makes much difference in the timing. Based on your photos you have fairly minimal jowling and any midface lift is likely to address the upper cheek area rather than the jawline. Also, have you considered simply fat grafting to the nasolabial fold and cheek areas rather than a lift. It may do the job.
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