Common Procedures

• Corrective Jaw Surgery (Orthognathic Surgery): This procedure is performed to correct abnormalities of the jaw bones that cause difficulty in biting, chewing, or breathing. The upper jaw (maxilla), lower jaw (mandible), or both may need to be repositioned to improve alignment and function.
• Wisdom Tooth Removal: Wisdom teeth may become impacted (unable to fully erupt) or cause crowding and misalignment of other teeth. Surgical removal of the impacted teeth is often necessary to alleviate pain and prevent further dental problems.
• Dental Implants: This is an option for replacing missing teeth and provides a stable and long-lasting solution for restoring function and aesthetics. They consist of titanium posts that are surgically implanted into the jawbone and topped with dental crowns. The implant fuses with the jawbone over time, providing a strong foundation for the crown.
• Treatment of Facial Injuries: This treatment involves surgically repairing fractures of facial bones (nose, cheekbones, jaw) from trauma or accidents to restore symmetry and function. The approach depends on injury location and severity, utilising plates, screws, or fixation devices for stabilisation.
• Treatment of Facial Deformities: This involves addressing congenital or acquired facial deformities, such as cleft lip and palate through surgical interventions aimed at improving appearance and function. Surgical techniques vary and include reshaping and repositioning facial bones and tissues.

Indications for Maxillofacial Surgery

Maxillofacial surgery may be required for a variety of reasons, encompassing both aesthetic and medical indications.

Medical indications for surgery include the following:

• Treatment of temporomandibular joint (TMJ) disorders: Surgery may be recommended for severe cases of TMJ disorders that do not respond to conservative treatments.
• Removal of impacted teeth: Maxillofacial surgery is often necessary to remove impacted wisdom teeth that are causing pain, infection, or damage to the adjacent teeth.
• Treatment of facial trauma: Surgery is often required to repair fractures of the facial bones resulting from trauma, such as motor vehicle accidents or falls.

Aesthetic indications for surgery include the following:

• Improvement of facial proportions: Surgery may be performed to enhance facial harmony and proportions, such as reducing a prominent chin or augmenting a weak jawline.
• Correction of facial deformities: Surgery can address congenital deformities such as cleft lip and palate, as well as acquired deformities resulting from trauma or disease.
• Correction of facial asymmetry: Maxillofacial surgery may correct asymmetry in the face caused by congenital conditions, trauma, or previous surgeries.

Benefits of Maxillofacial Surgery

• Improved Functionality: Maxillofacial surgery may improve the function of the jaw, teeth, and facial structures, leading to better chewing, speaking, and breathing.
• Better Oral Health: Surgery is performed to address issues such as impacted teeth, misaligned jaws, and facial trauma. This can help improve oral health and reduce the risk of dental problems.
• Enhanced Appearance: Surgery may correct facial asymmetry, deformities, and other aesthetic concerns, leading to a more attractive facial appearance and increased self-esteem.

Risks and Complications of Maxillofacial Surgery

• Swelling and Bruising: This is common after maxillofacial surgery. It can be managed with pain medications, ice packs, and elevation of the head. Medical attention is required if the symptoms become more severe.
• Infection: Bacteria entering the surgical site may lead to infection. Maxillofacial surgeons in Singapore follow strict sterile techniques to prevent this, and patients may receive antibiotics before and after surgery based on their risk factors and the procedure. Post-operative wound care instructions are also provided.
• Bleeding: Surgery involving the face and jaws can cause bleeding due to the rich vascular supply in these areas. Surgeons minimize bleeding by using cautery devices and pressure on the surgical site. In some cases, excessive bleeding may require additional measures such as blood transfusions or surgical revision.
• Nerve Damage: Surgery poses a risk of temporary or permanent nerve damage, potentially affecting sensation or movement in the face, lips, or tongue. Surgeons use advanced imaging techniques such as cone-beam computed tomography (CBCT) to visualize nerve pathways in order to avoid damage.

The Maxillofacial Surgery Process in Singapore

Maxillofacial surgery in Singapore follows a careful process, below are parts of this process:

Consultation and Planning

• Initial Assessment: The first step is a consultation with a maxillofacial surgeon. The surgeon will review the patient's medical history, perform a thorough physical examination, and discuss the reasons for considering surgery.
• Diagnostic Tests: Depending on the patient's condition, additional diagnostic tests such as X-rays, CT scans, or 3D imaging may be ordered to assess the structure of the face and jaws.
• Surgical Planning: Based on the assessment and diagnostic tests, the surgeon will develop a customised treatment plan, outlining the goals of surgery, specific procedures to be performed, and the expected outcomes.

The Surgical Procedure

• Anesthesia: Maxillofacial surgery is commonly conducted under general anesthesia, ensuring the patient is unconscious and devoid of pain throughout the procedure.
• Surgical Process: The surgical process varies based on the condition. Surgery may involve repositioning the jaw bones, removing impacted teeth, or reconstructing facial bones. Surgeons use advanced technologies such as computer-assisted surgery for optimal outcomes.
• Immediate Post-operative Care: After surgery, patients are monitored closely in the recovery room. Pain medications and antibiotics may be prescribed to manage pain and prevent infection. Patients will receive after-care instructions to manage any potential discomfort.

Recovery and Aftercare

• Recovery Timeline: The recovery timeline varies depending on the complexity of the surgery and the individual patient. Patients can expect some swelling and discomfort in the first 3 days following surgery.
• Post-operative Care Instructions: Patients will receive detailed instructions on how to care for the surgical site, including dietary restrictions, oral hygiene practices, and when to resume normal activities. Follow-up appointments will be scheduled to monitor healing and remove any sutures or splints.

Choosing a Maxillofacial Surgeon in Singapore

Selecting a maxillofacial surgeon in Singapore requires careful consideration to ensure optimal care. Look for accreditation in oral and maxillofacial surgery, training from reputable institutions, specialisation in your required procedure, and a proven track record of success. Reading patient reviews can also provide valuable insights into the surgeon's skills and patient satisfaction.

When consulting with surgeons, patients may consider asking the following questions:

• How complex is the surgery, and what are the associated risks?
• Can you explain the surgical technique you plan to use and why it is the best option for me?
• Are there non-surgical alternatives, and what are their advantages and disadvantages?
• Will I need any special preparations before the surgery?
• What post-operative care and follow-up appointments should I expect?
• Can you provide before-and-after photos of similar procedures?
• What is the total cost of the surgery, including follow-up care and potential revisions?

Maxillofacial surgery offers crucial solutions for facial, jaw, and oral conditions in Singapore. It is important to research and consult with qualified professionals to make informed decisions. Consider scheduling a consultation with a qualified maxillofacial surgeon to discuss the specific needs and concerns, and to determine if maxillofacial surgery is necessary.