What to expect from TMJ Surgery?
There are many things that can happen during the procedure. There are several procedures that are performed on your face such as:
• Facial Lift – This procedure involves removing part or all of your facial bone structure (bones) so they don’t interfere with breathing and movement. The face will look different after this operation.
• Facial Contouring – This procedure involves shaping the features of your face using plastic surgery techniques. You may have some changes in how you look.
• Botox injections – These injections are used to reduce wrinkles and other signs of aging. They are usually given at the same time as a facelift or facial contouring. Botox does not change your bones, but it reduces lines around your eyes and forehead, making them appear smoother and less defined.
• Eyebrow lift – This procedure involves lifting the eyebrows to make them appear higher. It is done to give the appearance of having a fuller brow.
• Chin reduction – This procedure involves reducing the size of your chin, which makes it appear smaller. It is done to make your face seem younger and thinner.
What’s the difference between these procedures?
Talk with the doctor about which one is right for you. They will also explain the benefits and risks of each procedure. Your choice should be based on your face structure, skin type, lifestyle, and how you want to look. The procedures are usually performed at the same time. If you choose just one procedure, it can be done at a different time.
What’s involved in the procedure?
The procedure is usually done as an outpatient procedure. This means you will not stay overnight in the hospital. Most of the time you can go home the same day. Before the procedure, you will be given medication to help you relax and numb your face, unless you have been prescribed something else by your doctor. The surgery usually takes about two hours, but this can vary depending on what is done. You will be given pain medication before, during, and after the procedure. You may have some swelling, bruising, or other temporary side effects from your surgery. The incisions will be closed with stitches that will be removed in their entirety when you go home. In some cases, dissolvable stitches may be used instead.
Who are the doctors performing the procedure?
The doctors specializing in this field are called otolaryngologists or plastic surgeons. Either one can perform the surgery. An otolaryngologist specializes in diseases, disorders, and surgeries of the ears, nose, and throat. A plastic surgeon is a doctor who specializes in surgery of the ears, nose, throat, face, and neck. This may be an advantage if you need other types of facial surgeries or cosmetic changes in addition to the ones for your jaw.
What are the risks and complications?
Every surgery has some risk. Serious risks of jaw surgery are uncommon, but include things like:
bleeding from the mouth or nose
damage to the facial nerve
post-surgical swelling and pain
foot drop (inability to raise your foot at the ankle)
slowed or hoarse speech
Tell your surgeon about all the medicines you take before the procedure. This includes both over-the-counter (OTC) and prescription medicines. There are some medicines that you should not take before this type of surgery, including blood thinners and anti-coagulants. Most surgeons will tell you what these are if you ask. Be sure to tell your surgeon about all the medicines you take, so they can tell you if you need to continue taking them or if you need to stop taking some.
If you are healthy and don’t have major health concerns, your risk of a complication is low. While you may have some temporary pain and swelling, these will usually go away after the first month or so.
How do I prepare for the procedure?
You may be asked to stop taking some medicines up to one week before surgery. Your doctor will let you know what to do. Tell your surgeon about any medicines you are taking.
You may be asked to have blood work done in order to check your overall health and to make sure that you do not have anemia or another condition that might increase your risk.
Your doctor will want to check you in the days before the procedure. Since the surgery involves cutting through bone, having a recent fracture or infection in that area may complicate your surgery and the bones may not heal properly after the surgery.
You will be given a time slot when you will be able to go home after the procedure. Arrive at the hospital on time.
If you have dental devices such as a bridge or dentures, you will most likely not be able to keep them after surgery. Take photos of any facial hair you may have so that it can be shaved or removed after surgery.
Talk to your doctor about how much hydration (water) you should have before and after surgery.
What happens during the procedure?
There are two main incisions that can be made during this surgery. One is from the ear to the chin. The other is from the ear to the shoulder on the back of the jawbone. The types of incisions and how they are positioned will change with the surgeon’s preference and how much movement is needed in your jaw. The skin incision may be hidden by hair that grows back after surgery.
The incisions allow the surgeon to expose the joint and loosen and separate the joint surfaces. The bone is then cut and repositioned. Joint surfaces are also removed and replaced to make room for the new joint. After this is done, the soft tissues covering the joint are stitched back together.
Most of what happens during surgery is beyond your view. However, you may be able to see some of what’s happening if you want. It can help to alleviate some anxiety. If you do want to watch, make sure to tell your surgeon before the procedure begins so that he or she can arrange for the best view for you.
What happens after the procedure?
You will probably spend several hours in the recovery room after surgery before you are sent to a private room. Once there, you will be asked to attempt several movements and asked if you are in pain every few hours.
If you are taking narcotic pain relievers, you will be given a patient controlled anesthesia machine (PCA) to help you control the amount of pain medication you receive.
After surgery, some patients report a sensation of ongoing vibration in their jaw. This is most likely due to the cutting of the nerve during surgery and should go away in time.
There may be temporary numbness in the lip and chin areas due to the surgery site.
Sources & references used in this article:
20-year follow-up study of disc repositioning surgery for temporomandibular joint internal derangement by S Abramowicz, MF Dolwick – Journal of oral and maxillofacial surgery, 2010 – Elsevier
Evaluation of TMJ surgery in cases not responding to conservative treatment by G Widmark, KE Kahnberg, T Haraldson, J Lindström – CRANIO®, 1995 – Taylor & Francis
Temporomandibular joint total joint replacement—TMJ TJR by LG Mercuri – 2016 – Springer