Q: Dr. Eppley, I looked through your blog but didn’t see this question so I thought I would ask you here. I know jaw augmentation has a high rate of swelling, so I wanted to ask; do you recommend someone wear a facial compression garment for say the first 4 or so days to help with this or would this not help/ be a hindrance to the healing process? Also, would taking something like Arnica montana and Bromelain be of any use in swelling/ bruising( from what I’ve read on some surgeons websites ). Thank you for your time.
A: Thank you for you inquiry about the management of swelling after any jaw augmentation/jawline implant enhancement procedure. While there may be no detailed information in my blog to date in this topic, there will be now.
Jaw augmentation can potentially cause some of the most proportionate swelling on the face after surgery. This is because it requires lifting up much of the outer portion of the masseter muscle to place the implants. Because the masseter muscle is the second largest muscle on the face (the temporalis is the largest and is more on the side of the head than on the face), any disruption of its attachments can cause some profound swelling. The amount of that swelling is partially affected by the extent of the muscle elevation and how the tissues are handled. But there is no getting around the fact that there will be some substantative muscle edema and swelling.
Knowing this in advance, steroids are given intravenously during surgery as a pharmaceutical management strategy. This is probably the most effective strategy for reducing the amount of swelling that would otherwise appear. A compressive wrap is placed after surgery for the first 18 to 24 hours and is taken down the next day. This, like steriods, is about steroid control not resolution. Any wearing of the compressive wrap beyond that time period is more for comfort and has not been proven to help swelling go down any faster. Arnica and Bromelain are homeopathic agents that are commonly touted and used after plastic surgery procedures as anti-bruising and anti-inflammatory modalities. While they are certainly harmless and inexpensive, no scientific controlled study has ever been done that provides conclusive proof of their benefit. But their lack of any side effects makes their use of, at least, some psychotherapeutic benefit.
Beyond what is done during and immediately surgery, time and healing is the only really effective agent that ultimately eliminates swelling after jaw augmentation.
Dr. Barry Eppley