Lower Jaw (Mandible) Reconstruction
When the bone of your lower jaw is rebuilt to the right shape, chewing, speaking and smiling can feel more comfortable again, and the face you see in the mirror can look more like the one you know.
Is this right for you?
Lower jaw reconstruction rebuilds bone that has been lost or damaged in the mandible, the curved bone that forms your chin and lower jaw. This surgery suits a wide range of people, and whether it is right for you depends on the cause, how much bone is involved, and your overall health.
This may be a good fit if
- You have lost or damaged part of your lower jawbone after an injury, after a tumour was removed, or because of a defect you have had since birth.
- Chewing, biting, speaking or closing your mouth has been affected, or the shape of your face has changed and you would like to restore it.
- You are healthy enough to go through a long operation under general anaesthetic.
- You understand that this is often a process of several steps that takes time and patience.
- You have clear, realistic ideas about what you hope to improve.
This may not be right if
- You have a medical condition that is not yet under control, which would make a long anaesthetic unsafe at this time.
- You smoke heavily and are not ready to stop during the period around surgery, because smoking slows the healing of bone and tissue.
- You expect your face to return to exactly how it looked before, when the realistic goal is to restore function and contour as closely as possible.
- Your situation could be handled with a less invasive approach that your doctor feels is more suitable.
How it works
Everything starts with a consultation. The doctors will ask about your medical history, what caused the defect, and what you hope for. You will usually have imaging, such as a CT scan (a type of scan that builds a three-dimensional picture of the bone), so your doctor can see clearly which part of the bone needs rebuilding and plan it in detail before the operation.
The surgery is done under general anaesthetic, which means you are fully asleep and feel nothing throughout the operation. Depending on how much bone is missing, your doctor may use a bone graft material, a small metal plate to hold things in place (usually titanium), or a piece of bone taken from elsewhere in your body, such as the fibula in your lower leg, together with its blood supply.
During surgery, your doctor reshapes the lower jawbone so that it is balanced with the rest of your face, then fixes the new bone into the correct position. If a piece of bone with its own blood supply is used, a team reconnects the small blood vessels under a microscope to keep the grafted bone alive.
Operating time varies a great deal from case to case, from a few hours to an operation that lasts most of a day in complex situations. Some people need several stages of surgery, spaced apart, to complete both the structure and the function.
Realistic expectations
The goal of lower jaw reconstruction is to restore structure, function and facial contour as closely as possible, not to create a new face. Understanding what the surgery can and cannot do helps you enter the process with the right expectations.
What this will not do
- The surgery does not return your face to exactly how it was before the damage; the goal is to come as close as possible.
- The surgery does not on its own fully restore feeling or movement if a nerve was already damaged beforehand.
- This is not a purely cosmetic procedure; the focus is on rebuilding the bone that was lost and the function that goes with it.
- The surgery does not replace treatment of the underlying cause, such as cancer treatment if the defect was caused by a tumour.
Recovery
Healing after lower jaw reconstruction takes time, and progress differs from one person to the next depending on how large the operation was. The stages below are general timeframes to help you picture things, not a fixed schedule.
- The first few days
- You stay in hospital for close monitoring. Swelling and discomfort around the jaw are normal and are managed with medication. You may be fed through liquids during this stage.
- About the first 1 to 2 weeks
- Swelling and bruising peak and then ease. You eat soft or liquid food and keep your mouth clean as instructed. If a piece of bone was taken from your leg, you will also need to care for that area.
- About 2 to 6 weeks
- Many people gradually return to light daily activity. Time off work depends on the nature of your job and the size of the operation, and can range from a few weeks to longer.
- About 2 to 3 months
- The grafted bone continues to knit together and grows steadier. Your diet may be widened step by step as your doctor judges the bone to be settled.
- Several months to more than a year
- The shape and function continue to settle over time. Some people need further steps such as dental restoration or small adjustments.
Risks & safety
Every operation carries risk, and because lower jaw reconstruction is major surgery, it is important to understand these clearly. Your doctor will talk through which risks are most relevant to your situation.
- Bleeding and infection, which may need further treatment with antibiotics or an additional procedure.
- The bone graft or bone flap not healing well, or part of the grafted bone not surviving and needing to be treated again.
- Nerve injury causing numbness, reduced feeling or weakness in the lip, chin or the area around the jaw; this may be temporary or longer lasting.
- Effects on your bite, your ability to chew or your mouth movement, which sometimes need further adjustment.
- Scarring at the surgical site on the face and where the bone graft was taken.
- Risks related to general anaesthetic and to a long operation, especially if you have an existing health condition.
- A shape result that is less balanced than you hoped for, which sometimes needs corrective surgery.
How we do it
Lower jaw reconstruction calls for several specialties working together. Here, the doctors plan from your own imaging, weighing both the bone that needs rebuilding and how that bone fits with your bite and your facial contour, before you ever reach the operating room.
We see honest conversation as part of your care. Your doctor will explain the options, the reasons for choosing a particular technique, and what you can expect through each stage, so that you decide alongside the team rather than simply receiving a set plan.
Frequently asked questions
Will this surgery hurt?
You are fully asleep during the operation under general anaesthetic, so you feel nothing. Afterward, pain and swelling around the jaw are normal in the first few days and are managed with medication as your doctor directs.
Will I have scars?
Yes. There will be a scar at the surgical site, and if the bone graft is taken from elsewhere, such as your lower leg, there will be a scar there too. Your doctor tries to place the incision as discreetly as possible, and scars usually fade over time, though they do not disappear completely.
How long will I need off work?
This depends on the size of the operation and the nature of your job. Many people need at least a few weeks, and heavy work may need longer. Your doctor will give you a timeframe that fits your situation closely.
Will my face look natural?
The goal is to restore your facial contour as closely as possible to how it was before. How natural it looks depends on the size of the defect and the technique used. Your doctor will talk honestly with you about what can be achieved in your particular case.
Will I be able to eat normally again?
Most people begin with liquid food, then soft food, and gradually widen their diet as the bone heals and grows firm. Some people need a further step of dental restoration to chew better. How well you eat later on depends on your individual case.
How long does the surgery take, and will I need to stay in hospital?
Operating time varies from a few hours to most of a day in complex cases. You will stay in hospital for a few days for close monitoring afterward. The exact number of days depends on your operation and will be discussed with you by the team beforehand.
Am I too old for this surgery?
Age on its own is not the deciding factor. What matters more is whether your overall health allows you to go through a long operation under anaesthetic. Your doctor will assess the whole picture before advising you.
Will I need more than one operation?
You might. Many cases are carried out in several stages to complete both the structure and the function, or need additional steps later on. Your doctor will outline the expected path for you from the start.
Where is the bone graft taken from?
Depending on your case, your doctor may use a bone graft material, a metal plate to hold things in place, or a piece of bone taken from elsewhere in your body along with its blood supply. The specific choice will be discussed based on your defect.
The next step
Every plan begins with a private consultation. Book a consultation to find out if this is right for you.
The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.