Do I need cosmetic jaw surgery?

Studies have shown that even babies instinctively gravitate towards an aesthetic face. Countless studies also showed that someone with a pleasing face has an advantage over competitiors who are more aesthetically challenged, be it in job applications, promotions, etc. So, it is little wonder that more and more people are prepared to improve their looks. Cosmetic jaw surgery often results in significant change in facial aesthetics as the jaws provide the framework for two thirds of the face, and in particular, the smile. 

So, back to the question of "Do I need cosmetic jaw surgery?', I would ask the patient whether she is happy with the way she looks. If she is, then the consutlation ends there. I will not put into her mind what I think she needs. Before the beholder, beauty lies in the mind of the person herself. But if the answer is no, then we will go into a deeper discussion of what she does not like, in an attempt to identify the feature that she is not happy with. With that in mind, I will proceed with a thorough assessment of the face.

While the perception of aesthetic may be intuitive to many, we need a quantitative system to base our assessment. First I look for any obvious facial disharmony. Some may have a cleft lip and palate that has been repaired before, others may have had a history of trauma to the face, perhaps from sporting injuries or road traffic accidents and some may even have had jaw surgery done elsewhere before. For the most part though, most patients have no obvious defect.

Then I look for general symmetry of the face. Nobody is symmetrical. It is a question of degree. So long as the asymmetry is not something that dominates the appearance of the face, it is not an aesthetic challenge. Asymmetry can come in the form of different levels of the eye, alignment of the nose, the smiline line of the teeth, the midlines of the upper and lower teeth, the position of the chin point, etc. 

Next we assess the face for general proportions. From top of the head to the chin, the face is divided into thirds and from side to side, the face is divide into fifths. Any disproportionate parts are noted and further assessed as we look at the individual features.

Once we are done with the face, we look at how the jaws meet, the alignment of teeth, the relationship of the upper jaw to the lower jaw, the function of the jaw joints, the relationship of the jaw and teeth to the soft tissue, ie the skin, covering them. We also look at the dynamic aesthetics such as the smile, whether the gums are showing, etc. 

After this preliminary examination, it's my turn to tell the patient what I found about her face, compared with established population norms. At all times, I will emphasize that regardless of what the population norms are, each individual is unique and at the end of the day, it is how you feel about your own appearance that matter. 

At the end of this first consultation, we go back to the first question, "Do I need cosmetic jaw surgery?" By now, the patient should be able to answer the question herself. If the answer is yes, then we will proceed to the next step, which is to take records such as Xrays, photos, moulds of the teeth, etc. We will then work with these records and work out treatment plan and a computer simulation of the possible surgery. A second discussion appointment will be made in a week or two to go through the plan. This is an important process as we all have our own preference as to what is aesthetic. I need to understand what the patient is looking for and the patient need to understand what surgery can do and cannot do.