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AGAVE clinic
Facial feminization
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Jaw surgery
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Cleft lip and palate
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Jaw surgery


Surgery of the Lower Jaw

Incisions are carried out completely inside of the mouth.
Before retraction of the lower jaw.   After retraction of the lower jaw.
Before advancement of the lower jaw.   After advancement of the lower jaw.

Patient information

  • Mandibular wisdom teeth removed well in advance
    • It is generally wise to plan for the mandibular wisdom teeth to be removed well in advance of the mandibular split surgery, since they can make the surgery more difficult. Experienced surgeons can remove the tooth and obtain a successful split, but almost all try to avoid this situation because it may increase the risk of an unplanned mandibular fracture and can make the placement of the screws more difficult.
  • Numbness in lower lip/chin lasting from weeks to months
    • A major drawback of the sagittal split osteotomy is the risk to the mandbibular nerve, which innervates the lower lip and chin an this should be mentioned. The patient has to be informed about numbness of the lower lip and chin for some weeks to months postoperatively.
  • Risk of permanent 'altered sensation' in lower lip and chin
    • In most cases normal sensation returns though occasionally an altered sensation remains which does not lead to distortion, or impairment of the function of the lips. In most cases the patient gets accustomed to it.
  • Screws do not need removing
  • No intermaxillary fixation
    • An advantage of the sagittal split osteotomy is the possiblity of screw fixation avoiding the need for intermaxillary fixation during a number of weeks.
  • Problems of the temporomandibular joint
    • Postoperatively, temporomandibulair joint complaint are not uncommon, as during the operation the mouth is opened wider than normal, and the teeth do not always fit together completely afterwards. A 'tired feeling' around the cheeks and ears may occur temporarily and occasionally supportive physical therapy may be necessary.
  • Soft diet for five weeks
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