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 plastic surgeons trained in multiple 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 for your oral health and aesthetic surgery 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 will emerge and collide with the other molars. 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 wouldn’t cause problems. But as you age, the roots of wisdom teeth become longer and the jaw bone becomes denser which 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 undergoing a jaw reduction surgery. 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 have a more feminine appearance. 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 wisdom 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 Dr. Deschamps-Braly 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 that 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 a more complex surgical procedure.
Depending on the position of your wisdom teeth and your age, extraction can affect your jawbones and cheeks, especially if you are older than your early 20s. Anything that affects your upper jaw, lower jaw or cheeks could impact the aesthetics of the look you have achieved with previous facial reconstructive surgery.
Even if there are no complications, some people just don’t like the way their face looks after their wisdom teeth have been removed. Correcting this might require more surgical procedures.
POTENTIAL CONSEQUENCES OF WISDOM TOOTH REMOVAL ON FFS SURGERY
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?
- Orthognathic (Jaw) Surgery
- Jaw Contouring (Reshaping/Tapering)
- Facial Feminization Surgery – Overview
- Key Elements of Facial Feminization for Women with Masculine-Looking Faces
- Considering Facial Feminization? Unsure About V-Line Surgery vs Feminizing Jaw Surgery?
References – for those who like to dig deeper
- Approach to Feminization Surgery and Facial Masculinization Surgery: Aesthetic Goals and
Principles of Management.
- Deschamps-Braly JC. Journal of Craniofacial Surgery, 2019; Apr 2 [Epub ahead of print].
- Feminization of the Chin: Genioplasty Using Osteotomies.
- Deschamps-Braly J. Facial Plastic Surgery Clinics of North America, 2019;27(2):243–250.
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.