Which to Do First - Mandibular Advancement or Midface Lift?

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.

Doctor Answers 10

Mandibular Osteotomy Should be Done Before Any Midface Lifting

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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

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Simplistically put, it is always best to complete the foundation and the building walls before worrying about wall paint and window treatments. By positioning the mandible where it should be, the subsequent facial changes would be made to the new face and mandible. Doing it the other way may have the mandible changes result in unwelcome changes to the facelift. Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Mandibular advancement or mid face lift.

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I would recommend that you proceed with the facial skeleton and bone work prior to considering soft tissue work.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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Perhaps your mandibular advancement should be done with your orthodontics

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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.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Order of Surgery - Mandibular Advancement and Midface Lift

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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.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Midface lift or mandibular surgery

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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.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Order of mandibular advancement with facial surgery

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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.

A. John Vartanian, MD
Glendale Facial Plastic Surgeon

Mandibular Advancement before Midface Lift

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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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Bony surgery before Midface lift

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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.

Dr. ES

Timing of facial cosmetic surgery

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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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