Collapsed jaw due to teeth extraction. What can I do to help?

Question

I’m 34(F) and have had several teeth pulled and have not gotten implants yet. It’s been over a year and a half and I can see that my jawline has changed significantly. I feel like it’s beginning to collapse, my jawline looks shorter and less defined. Eventually I will get teeth implants and bone grafts, but are there any treatments or surgery that can correct what has happened? Would an appliance like the Vivos or ALF help reverse this?

Hung William Song, MD · Answer

You are absolutely right, the loss of teeth can change your jawline and make your face look collapsed. If the reason you have not gotten implants is because of the cost, I would suggest saving your money and getting the implants as soon as possible before more bone loss occurs. However, if the cost is not the issue and you want to have cosmetic improvement until you can get the implants, dermal fillers can certainly be used to temporarily correct the appearance of the facial collapse. Using a product like Radiesse and having it placed right on the bone can give a nice cosmetic correction.

Jason Emer, MD · Answer

Thank you for your question, For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Nirmal Nathan, MD · Answer

Dear Rational9669,Thanks for your question. Given that your bone loss is likely due to the teeth being pulled, filler is not an optimal solution. You need bone grafting or possible jaw surgery to correct these kind of issues. As a craniofacial surgeon, I can attest that filler is not a good solution for this problem...although it can be reverse priort o any surgeries you may need.Good luck,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgeons
  
ACGME-trained Craniofacial Surgeon

Philip S. Schoenfeld, MD, FACS · Answer

You are absolutely correct in your observation.  Without the presence of teeth in the jaw there is rapid resorption of bone along the jawline due to the absence of the pressure forces that maintain the bone integrity.  At 34 I would put dental implants high on the list though I understand that cost can be an issue.  I think that you are going to require jaw sculpting with fillers such as Radiesse even with dental implants as the jaw bone will not likely regenerate.

Michele S. Green, MD · Answer

I have seen this happen many times and unfortunately you need to have the tooth implants done and bone grafts.  The lasers an fillers would not be appropriate for this.  Please wait and have the surgery and then have it evaluated.  Best, Dr. Green

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