Jaw Contouring for FFS and Wisdom Teeth

Jaw Contouring for Facial Feminization Surgery and Extraction of Wisdom Teeth

If you are considering facial feminization surgery (FFS) and you haven’t had your wisdom teeth removed, we recommend an analysis of the state of your teeth and an integrated approach to any surgeries required.

Removing your wisdom teeth – or any other corrective surgery to your jaw – can impact the overall aesthetics of your face and is best considered in the context of any future FFS.

Consulting with a surgeon trained in three surgical specialties and with proven expertise in the artistry of facial feminization, such as Dr Deschamps-Braly, has the advantage of facilitating an integrated approach and optimal timing for any surgeries needed and is more likely to give you the best possible result.

The Case for Removing Wisdom Teeth Before FFS

Most people have 32 permanent adult teeth, with four wisdom teeth emerging between 17 years of age and the early 20s. Typically, one wisdom tooth is located at the very back of each row of teeth on each side of the upper and lower jaw.

In many people, the wisdom teeth become impacted – meaning they cannot properly emerge. There are different degrees of impaction, but in general it can create problems including:

  • Difficulty in cleaning
  • Infection & cysts
  • Crowding of the teeth that force the positioning of other teeth to become irregular, especially at the front
  • Damage and pressure on neighboring teeth
  • Wisdom teeth that cannot emerge and remain embedded in the jaw bone

Some people don’t have their wisdom teeth removed as young adults because the teeth were not causing problems. But as you age, the roots of wisdom teeth become longer and the jaw bone becomes denser and this means problems become more likely.

Problems with wisdom teeth can occur at any time but are more likely to occur in your 30s. In addition, the removal of wisdom teeth is more likely to cause complications when you are older, as the roots have grown further into the bone.

For all these reasons, if you are considering FFS, we recommend thinking about removing your wisdom teeth before FFS. If problems with the teeth emerge after FFS, extracting the wisdom teeth may affect any previous jaw surgery and affect the overall aesthetics of the feminine face you worked so hard to achieve.

Advantages of Having FFS after Extraction of Wisdom Teeth

In terms of the aesthetics of the face, some people find removing their wisdom teeth makes their jaw appear narrower and their facial features more defined. While some might consider this a benefit, especially in their youth, others have reported their face appeared gaunt and looked older.

Your FFS surgery is best designed to correct and perfect your look after you have had any other structural surgeries to your jaw such as extraction of wisdom teeth or corrective jaw surgery (orthognathic surgery).

Extraction of wisdom teeth before FFS can have the following benefits:

  • If you are unhappy with the way your face looks once the teeth have been removed (gaunt cheeks, aging etc.), you can discuss the potential for improving the aesthetics of your face during FFS.
  • Without wisdom teeth, the surgeon can more easily design any jaw bone cuts required to give you the best result with FFS – the presence of wisdom teeth can affect the surgeon’s ability to cut your jaw bone.
  • Any previous jaw contouring for FFS might affect the outcomes of wisdom tooth extraction, especially if you are older than your early 20s and the roots of your wisdom teeth have grown further into your bone.
  • If you have more serious complications after tooth extraction, you might need further surgeries which might affect the aesthetics of your face.
    Any asymmetries in your jawline after wisdom teeth have been removed can potentially be corrected by FFS.

Disadvantages of Removing Wisdom Teeth after FFS

Like any medical procedure, removing wisdom teeth can have complications, especially if you have a severe impaction requiring more complex surgery.

Depending on the position of your wisdom teeth and your age, extraction can affect your jaw bones and cheeks, especially if you are older than your early 20s. Anything that affects your upper jaw, lower jaw or your cheeks could impact the aesthetics of the look you have achieved with previous FFS.

Even if there are no complications, some people just don’t like the way their face looks after the wisdom teeth have been removed. Correcting this might require more surgeries.

Extraction of wisdom teeth can cause short-term complications that are less likely to affect previous FFS, including:

  • Temporary swelling of the cheeks and jaw in the days after the procedure
  • Infection – can be treated with medication or draining and cleaning of the area
  • Dry sockets – caused by the loss of the blood clot in the empty tooth socket

Other complications that could impact the aesthetics achieved with previous FFS surgery include:

  • Damage to nearby teeth
  • Damage to the sensory nerve in the lower jaw – usually temporary tingling or numbness in the lower lip, chin or tongue
  • Lower jaw bone breaks
  • Sinus communication – removal of upper teeth can create an opening between your mouth and sinuses

Want to know more?

References – for those who like to dig deeper

board-certified plastic and craniofacial surgeon at | + posts

Dr. Deschamps-Braly is a board-certified plastic and craniofacial surgeon specializing in facial plastic surgery, orthognathic (jaw) surgery, and craniofacial surgery for adults and children. He is also one of the world’s foremost leaders and innovators in facial gender confirmation surgery.