Maxillofacial Surgery – Cost, Meaning, Before and After, Procedures

Key Facts

Maxillofacial surgery is a specialized branch of surgery that deals with the diagnosis and treatment of diseases, injuries, and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral (mouth) and maxillofacial (jaws and face) region
It encompasses a wide range of procedures from minor tooth extractions to complex reconstructive surgeries
Some common procedures in maxillofacial surgery include wisdom teeth removal, jaw surgery, dental implant surgery, and facial trauma treatment
Maxillofacial procedures are relatively common, with millions of people undergoing various treatments each year
This field is essential for managing conditions that affect chewing, speaking, breathing, or the appearance of the face and jaws

What is Maxillofacial Surgery?

Maxillofacial surgery is a medical specialty focusing on the diagnosis and surgical treatment of various conditions affecting the face, jaws, mouth, and related structures. The term maxillofacial is derived from maxilla, which refers to the upper jaw, and facial pertaining to the face. Maxillofacial surgeons are trained to address a wide range of issues, including those related to the teeth, soft tissues of the mouth, jaw alignment, facial bones, and more. These surgeons can perform procedures ranging from simple tooth extractions to intricate surgeries for correcting jaw deformities or reconstructing the face following trauma.
Maxillofacial surgeons are often dual-qualified in medicine and dentistry, which equips them with the expertise required for procedures involving the oral cavity and surrounding facial structures. They work closely with other specialists such as orthodontists, oncologists, neurosurgeons, and plastic surgeons, depending on the nature of the condition being treated.

Why is Maxillofacial Surgery Done?

Maxillofacial surgery can be performed for a variety of reasons, ranging from improving function to enhancing facial aesthetics.
Here are some common reasons for maxillofacial surgery:

Impacted Teeth: Impacted teeth, commonly the wisdom teeth, are those that have not erupted properly and can cause pain or affect the alignment of other teeth. Surgical removal is often necessary.
Jaw Misalignment: Conditions like underbites, overbites, or other jaw misalignments can affect speech, chewing, and appearance. Corrective jaw surgery can alleviate these issues.
Facial Trauma: After an accident or injury that causes facial trauma, maxillofacial surgery can be used to repair fractures and soft tissue injuries, and ensure the proper functioning of the mouth and jaw.
Tumors and Cysts: Abnormal growths in the mouth, jaws, or facial bones require surgical intervention for removal and, if malignant, additional treatment for cancer.
Temporomandibular Joint (TMJ) Disorders: These disorders affect the joint that connects the jaw to the skull. Surgery may be necessary in severe cases.
Dental Implants: Maxillofacial surgeons often perform surgeries to insert dental implants, which are artificial tooth roots used to support dental prosthetics.
Cleft Lip and Palate Repair: These are common birth defects where a child’s lip or mouth do not form properly during pregnancy. Surgical repair is often necessary.
Sleep Apnea: In severe cases of sleep apnea, maxillofacial surgery can be used to remove excess tissue from the throat, helping to alleviate symptoms.
Reconstructive Surgery: This is performed to rebuild the structure of the face and jaw, usually after trauma, surgery for tumors, or as part of orthognathic surgery.
Aesthetic Surgery: Sometimes, maxillofacial surgery is performed for purely aesthetic reasons, such as face-lifts, rhinoplasty, or chin augmentation.

Collaborative Approach

Maxillofacial surgery often involves a collaborative approach, especially for complex cases. The maxillofacial surgeon may work with an orthodontist in cases of jaw misalignment, with an oncologist in cases of oral cancer, or with a plastic surgeon for reconstructive surgery.

Importance in Oral Health and Quality of Life

The importance of maxillofacial surgery extends beyond the treatment of diseases. It plays a vital role in improving the quality of life for individuals by enhancing function, alleviating pain, and in many cases, improving aesthetic aspects of the oral and maxillofacial region.

What’s the Difference Between Oral Surgery and Maxillofacial Surgery?

Oral surgery and maxillofacial surgery are closely related fields, and there is often confusion between the two.
Here is how they differ:

Scope of Practice

Oral Surgery: Primarily focuses on the surgical procedures of the mouth and includes dental extractions, dental implants, and surgery of the teeth and alveolar bone.
Maxillofacial Surgery: Encompasses a broader scope, covering the entire facial region, including the jaws. In addition to procedures performed in oral surgery, it includes corrective jaw surgery, cleft lip and palate surgery, facial trauma surgery, and surgery for tumors and cysts of the jaws and face.

Training

Oral Surgeons: Typically, complete dental school followed by a residency in oral surgery.
Maxillofacial Surgeons: Usually undergo a more extended training, which may include dental school, medical school, and surgical residency. Some maxillofacial surgeons receive additional training in plastic and reconstructive surgery.

Medical Versus Dental

Oral Surgery: Is more dental-centric and usually addresses conditions that are primarily dental in nature.
Maxillofacial Surgery: Blends medical and dental aspects and often involves more complex surgeries that require a comprehensive understanding of facial anatomy and function.

What Happens Before Maxillofacial Surgery?

Before undergoing maxillofacial surgery, several steps are usually involved:

Initial Consultation: This involves a detailed discussion with the maxillofacial surgeon. The surgeon evaluates your medical history, conducts a physical examination, and discusses the options for surgery.
Diagnostic Imaging: Imaging tests such as X-rays, CT scans, or MRIs may be ordered to assess the underlying structures and plan the surgery.
Preoperative Assessment: Depending on the complexity of the surgery, you may undergo a preoperative assessment to ensure that you are in good health for the procedure. This could include blood tests and assessments by other specialists.
Informed Consent: The surgeon will explain the risks, benefits, and alternatives of the surgery, and you will be asked to provide consent for the procedure.
Fasting and Medication: You will usually be instructed not to eat or drink for a specific period before the surgery, and there may be instructions regarding your regular medications.
Planning and Scheduling: The surgery will be scheduled, and you will receive information on where to go and what to expect on the day of surgery.

What Happens During Maxillofacial Surgery?

The procedures during maxillofacial surgery can vary widely depending on the specific type of surgery being performed.
Here are the general steps:

Anesthesia: Most maxillofacial surgeries require anesthesia. This can range from local anesthesia for minor procedures to general anesthesia for more extensive surgeries.

Surgical Procedure: The surgeon will perform the surgical procedure which can range from removing a tooth, realigning jaws, repairing facial fractures, and removing tumors, to reconstructing facial structures.

Monitoring: Throughout the procedure, your vital signs will be monitored to ensure your safety.

Closing the Surgical Site: After the procedure, the surgeon will close the surgical site using sutures.

Recovery Room: Once the surgery is complete, you will be moved to a recovery room where you will be monitored as the anesthesia wears off.

Post-operative Instructions: Before being discharged, you will receive instructions for post-operative care, including pain management, wound care, and follow-up appointments.

Maxillofacial surgery, like any surgery, should be approached with careful consideration and understanding of the procedure. It’s important to have good communication with your maxillofacial surgeon and follow all pre-operative and post-operative instructions for the best outcome.
The complexity and duration of the procedure depend on the type of surgery being performed. Maxillofacial surgery can be quite extensive, especially if it involves reconstruction or repair of multiple structures in the face and jaw area. It is essential to follow the surgeon’s instructions carefully to minimize complications and promote healing.

What Happens After Maxillofacial Surgery?

After maxillofacial surgery, the recovery process begins.
Here are the steps generally involved in the post-operative phase:

Immediate Recovery: Right after the surgery, you will be in a recovery room where nurses will monitor your vital signs as you recover from anesthesia.
Pain Management: It’s normal to experience some pain and discomfort. You’ll likely be prescribed pain medication. It’s important to take it as instructed.
Dietary Restrictions: Initially, you might be on a liquid or soft food diet. Gradually, as you heal, you will be able to return to a regular diet.
Oral Hygiene: Keeping the mouth clean is crucial. However, you might have to avoid regular brushing and flossing initially and instead use antiseptic mouthwashes.
Activity Restrictions: Depending on the complexity of the surgery, you may be advised to restrict physical activity for a certain period.
Follow-Up Visits: You’ll have appointments with your surgeon to monitor your healing process. It’s important to attend these appointments and discuss any concerns.
Long-term Recovery: Some maxillofacial surgeries, especially major reconstructions, may have a prolonged recovery period. Adhering to your doctor’s instructions is crucial for successful recovery.

What are the Advantages of Maxillofacial Surgery?

Correcting Jaw Misalignment: Helps in improving biting function and appearance.
Removing Tumors and Cysts: Surgery can effectively remove benign or malignant growths in the maxillofacial region.
Repairing Facial Trauma: Helps in reconstructing the face after injuries.
Treating Cleft Lip and Palate: Significantly improves speech, eating, and appearance in patients with these conditions.
Relief from TMJ Disorders: Can provide relief from chronic jaw pain and dysfunction.
Improved Quality of Life: By resolving functional and aesthetic issues in the maxillofacial area, the surgery often leads to improved self-esteem and quality of life.

What are the Risks or Complications of Maxillofacial Surgery?

As with any surgical procedure, maxillofacial surgery has potential risks and complications:

Infection: As the mouth is full of bacteria, there’s a risk of infection after surgery.
Bleeding: Some amount of bleeding is common, but excessive bleeding is a complication.
Scarring: Though surgeons attempt to minimize scarring, it can still occur, especially with extensive surgeries.
Nerve Damage: In some cases, surgery can cause temporary or permanent numbness or altered sensation in areas of the face or mouth.
Issues with Anesthesia: As with any surgery involving anesthesia, there’s a risk of allergic reaction or complications due to anesthesia.
Delayed Healing: In some cases, the healing process can take longer than expected.
Relapse: Particularly in corrective jaw surgeries, there’s a risk that the bones may shift back towards their original position.
Difficulty in Jaw Functioning: Sometimes the surgery can lead to difficulty in opening and closing the jaw, particularly in the initial phase of recovery.

It is important for patients to be well-informed and to weigh the benefits against the potential risks and complications. Proper pre-operative preparation and post-operative care are critical in minimizing the risks associated with maxillofacial surgery. Also, choosing an experienced and competent maxillofacial surgeon is vital for the success of the procedure.

What’s Recovery Like After Maxillofacial Surgery?

Recovery after maxillofacial surgery can vary widely depending on the nature of the surgery and individual factors.
However, here is an overview of what to generally expect:

Pain and Discomfort: Pain, swelling, and discomfort are common in the initial days after surgery. Your doctor will prescribe pain medication to help manage this.
Dietary Changes: For the first few days or weeks, you may need to stick to a soft or liquid diet to avoid putting stress on the surgical site.
Oral Hygiene: Keeping your mouth clean is crucial, but you will need to be gentle. Your healthcare provider will likely recommend rinsing with a saline or antimicrobial mouthwash.
Activity Limitations: Your doctor may advise you to limit physical activity and avoid lifting heavy objects for a period of time after surgery.
Stitches and Bandages: If you have stitches or bandages, your doctor will provide instructions on care and tell you when to come back to have them removed.
Follow-Up Appointments: It’s important to keep all follow-up appointments to monitor your progress and address any concerns.
Long-Term Recovery: Some patients might need additional rehabilitation or therapy, especially if the surgery was extensive.

When Should I Call My Healthcare Provider?

After maxillofacial surgery, it’s important to know when to seek help.
You should call your healthcare provider if you experience:

Excessive Bleeding: Some bleeding is normal, but if it’s excessive or doesn’t stop, it’s a concern.
Severe Pain: If pain is not relieved with the prescribed medications or gets worse.
Signs of Infection: Such as fever, chills, increased swelling, or a foul taste in the mouth.
Difficulty Breathing or Swallowing: Any difficulty in breathing or swallowing should be addressed immediately.
Numbness: If you experience unexpected numbness that does not improve.
Reaction to Medications: If you have an allergic reaction to the prescribed medication or any unusual side effects.

Bottom Line

Maxillofacial surgery can be a complex procedure that offers the potential to greatly improve the function and appearance of the mouth and facial structures. The recovery process requires patience, adherence to post-operative care instructions, and close communication with your healthcare provider. It’s important to follow all post-operative instructions, maintain a nutritious diet, practice gentle oral hygiene, and avoid tobacco and excessive alcohol consumption. Be aware of any signs of complications and do not hesitate to reach out to your healthcare provider if you have any concerns. The goal of maxillofacial surgery and the subsequent recovery process is to achieve the best possible outcome for your oral and overall health.

This article is complete and was published on August 22, 2023, and last updated on August 26, 2023.