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Jaw Reduction (V-Line Slimming)

Dr. Rad is highly sought after by patients who want to reduce the appearance of their jaw due to his expertise in improving facial balance and harmony. A wide jaw can make the chin look too short and make an otherwise attractive face look out of balance, in which case slimming the jawbone can bring better overall lower facial proportions. Dr. Rad’s goal in his chin enhancement work is to help patients feel more self confident that their facial features appear natural, not to look “done” or altered.

Patients choose to have jawline augmentation for different reasons, from simply wanting to feel less self conscious to restoring facial balance. Interestingly, a 2007 scientific study found that the chins and jawlines of 90% of CEOs of Fortune 500 companies were deemed “strong appearing” compared with only 40% in the general population. Regardless of motivation, Dr. Rad’s patients often feel that their jaws draw attention for the wrong reasons and they want natural results. Overall, Dr. Rad’s goal is to improve balance and harmony to patients’ faces so they can feel more confident in their appearances.

“Plastic surgery is the craft of enhancing beauty without the evidence.”

- Ariel N Rad, MD, PhD, FACS

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01Artistry

Artistry is at the heart of jaw reduction surgeries because together we are searching for restoration of facial balance and harmony. All surgeons have a different degree of aesthetic sense, some more than others. Dr. Rad’s eye is trained to evaluate a face both holistically and at the smallest details, looking for disproportionate features and optimal contours. Dr. Rad spends time with you to formulate the best plan to achieve your goals. This often requires a combination of procedures, from jawline reduction and deep neck sculpting, to buccal fat removal and rhinoplasty. Each procedure is intended to correct a prominent jaw, but keep in mind that the art lies in the hands performing the procedures, not the procedures themselves. Just as a beautiful piano concerto stands in its own beauty, it’s the pianist who brings it to life, some better than others. Likewise, surgeons have different skill levels and aesthetic nuance, and bring to life the best results to varying degrees of ability. The level of artistry required to achieve natural, beautiful and long lasting results requires tremendous nuance. As Dr. Rad frequently says, “millimeter changes throughout the face can synergize beautifully into stunning yet natural results.” These details are reflected in surgeons’ before/after photographs which is why you must evaluate these with an aesthetic eye. You have only 1 face and so listen to your instincts when you look at surgeons’ results.

02Safety

Experience is everything when it comes to safety. Dr. Rad has performed thousands of facial operations and prides himself in achieving beautiful, natural results for both women and men, and he operates with safety at top of mind by working with expert anesthesia and nursing teams at DC’s top hospital-based surgery centers. In Dr. Rad’s hands, jaw reduction surgery entails low risk and safety is always top of mind. Dr. Rad’s innate familiarity with facial anatomy, knowledge of safe navigation of the delicate nerves, muscles and blood vessels, and working with expert anesthesia and nursing teams, all translate to keeping patients safe.

03Technique

The technique involves the following process:

More information coming soon.

04recovery

Recovery is a process of tissue healing and feeling back to normal that requires time. The length of time depends on which facial areas are treated, the complexity of surgery, and individual healing factors. The key principle of surgery that Dr. Rad always adheres to is minimizing surgery to achieve best results, thus minimizing healing and recovery time. Since each case is different, Dr. Rad will guide you through the recovery process with comprehensive information based on your unique situation.

Jaw reduction surgery involves minor discomfort for several days, although temporary and minor swelling is normal and may take several weeks to resolve.

05Aftercare

06longevity

frequently askedQuestions

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What anesthesia is used for a Jaw Reduction?
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Jaw Reduction procedures require anesthesia to ensure patients’ comfort and safety during surgery. The choice of anesthesia depends on various factors, including surgeon preference, the extent of the procedure, the patient’s health status (presence of heart, lung, kidney or endocrine illnesses), and patients’ preference. The 3 most common types of anesthesia used for jaw reduction surgeries are:

General Anesthesia (GA)

Patients are asleep and are unaware during the surgery. During GA, the anesthesia team administers a combination of anesthetics to optimize the depth of anesthesia while minimizing side effects. This usually involves propofol for quick induction, and inhaled gas anesthetic for stable maintenance, and an array of anti- medicines to reduce nausea side effects, the most common issue with GA.

In terms of what patients experience, your last memory of the process is rolling into the OR, and then the next memory is waking up in the recovery room. You feel nothing or experience nothing of surgery. Dr. Rad’s anesthesia teams are exceptionally skilled in ensuring comfort and safety. Patients do not experience “waking up” episodes, nor do they have any memory of the procedure.

GA involves administering intravenous medications and inhaled anesthetic to induce sleep and keep the patient pain-free throughout the procedure. This involves an airway tube (“endotracheal tube”) which serves two purposes: (i) to deliver the inhaled anesthetic which gives long lasting anesthesia, and (ii) protects your windpipe preventing any fluids, secretions or phlegm from getting into your lungs which can cause a pneumonia or airways spasm/constriction (“laryngospasm”). Without protection of your airway, such as with IV sedation only, the risk of airway/lung problems is higher.

Patients awaken quickly because the depth of anesthesia is not nearly as deep as required for other types of surgery (think liver, kidney or heart surgery). Within 15-20 minutes you are awake enough to remove the airway tube, and then you are rolling to recovery. Typically patients stay for a couple or a few hours in recovery before going home.

This type of anesthesia is needed when deep plane face and neck lift with deep neck sculpting (gland reduction) is being done.

Dr. Rad advises not thinking of GA as “being on a breathing machine” or being dangerous. Rather, the anesthesia machine is supporting your natural breathing and protecting your airway. In fact, GA is for comfort and safety. In the hands of a board certified anesthesiologist (with whom Dr. Rad always works) in the safest possible environment (accredited hospital-based surgery centers) GA is very safe, in fact it is much safer than the cumulative risk of driving a car every day.

IV Sedation with Local Anesthesia

In some cases, combining sedation with local anesthesia (injected numbing medicine) is used. In this case, patients often receive propofol for the IV anesthetic to induce sedation and which helps them relax and feel drowsy during the procedure. While the patient is not fully unconscious with this approach, they are generally not aware of the surgery and experience little to no discomfort.

This does not involve the inhaled anesthetic as in GA, and does not require an airway tube. You are breathing on your own and the anesthesiologist will maintain your level of anesthesia with propofol and other IV medicines. Oxygenation is supported with supplemental oxygen.

Patients may be a candidate for this type of anesthesia for shorter procedures and neck lift that does not involve deep neck sculpting.

Local Anesthesia Only

This type of anesthesia is the simplest of all, and involves injecting numbing medicine throughout the tissues to be lifted. Dr. Rad uses local anesthetics routinely in the office and this does not require going to an OR.

We start with applying topical numbing which dulls sensation, then injected numbing medicine is given while you are awake.

Patients are candidates for this approach when undergoing in-office mini-face lifts, upper blepharoplasty, buccal fat reduction and direct brow lifts.

Overall, the choice between these types of anesthesia will be discussed during the pre-operative consultation with the surgeon. The surgeon will consider the patient’s medical history, the complexity of the procedure, and the patient’s preference when deciding on the appropriate anesthesia.

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Where does Dr. Rad have hospital operating privileges?
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You may hear that the safest plastic surgeons have “operating privileges” at major hospitals. “Operating privileges” allow surgeons to perform surgery at that hospital, and they are granted following a 6-month process of evaluating a surgeon’s background.

Dr. Rad’s credentials have rigorously been vetted by the top hospitals in DC and northern Virginia, specifically Sibley Hospital (DC), Inova Fairfax Hospital and Fair Oaks Hospital (northern VA), and George Washington University Hospital (DC). This means that his training, board certification and safety record meet the high standards of these top hospitals in DC and northern Virginia.

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What skincare should I use to optimize my healing?
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Proper skin care is critically important as your tissues will be inflamed after surgery. “Inflammation” is a common term that is commonly associated with harmful internal processes. However, inflammation is a normal process whereby the immune system is activated to heal tissue trauma caused by surgery. This is a normal part of healing. However, too much inflammation can be harmful and so we must be sure to avoid anything that can irritate your skin or worsen inflammation.

It is important to use the right products immediately after surgery. Dr. Rad recommends avoiding products that have stimulatory ingredients such as retinols and using gentle skin care with products that have high concentrations of antioxidants to calm and soothe inflamed skin. Drs. Sherber and Rad recommend the following curated, science-backed products for daily use after jaw reduction surgery (you may order products online or ask our staff for these products from our Boutique). Products are at different price points but we have vetted these products for their high quality ingredients and calming formulations for optimal jaw reduction healing.

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How do I prepare for a Jaw Reduction?
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If you are planning to undergo a jaw reduction surgery, it is important to properly prepare for the procedure to ensure the best possible outcome. Here are some tips to help prepare for a jaw reduction:

  • Follow your surgeon’s instructions: Your surgeon will prepare for the procedure to ensure the best possible outcome. Follow these instructions carefully to avoid any complications.
  • Stop smoking: Smoking can interfere with the healing process, and it is recommended to stop smoking at least two weeks before the procedure.
  • Avoid blood-thinning medications: Some medications, such as aspirin and ibuprofen, can increase the risk of bleeding during and after surgery. Avoid these medications at least two weeks before the procedure.
  • Arrange for someone to drive you home: You will need someone to drive you home after the procedure as you will feel groggy from the anesthesia.
  • Prepare a comfortable recovery area: Prepare a comfortable area for you to rest and recover after the procedure.
  • Stock up on supplies: make sure to stock up on supplies like ice packs, gauze, and comfortable clothing before the procedure
  • Follow a healthy diet: A healthy, well-balanced diet can help improve the healing process, so make sure to eat plenty of fruits and vegetables leading up to the procedure.

It is important to have a thorough consultation with your surgeon to properly understand the procedure and discuss any specific preparations that need to be made.

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    What is the cost of a Jaw Reduction surgery at SHERBER+RAD?
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    In Dr. Rad’s DC practice, the RANGES OF cost for CHIN + JAW RESHAPING ARE: CHIN AUGMENTATION WITH IMPLANT $4,900 – $6,900; JAW AUGMENTATION WITH IMPLANTS $6,500 to $9,500; CHIN REDUCTION $4,900 FOR SHAVING TO $9,500 FOR OSTEOTOMIES WITH PLATES/SCREWS; $7,500 to $20,000 for corrective work or extensive total facial rejuvenation. Keep in mind these are approximate ranges and total cost depends on multiple factors: your unique anatomy, goals, complexity of the procedures, recommended techniques, whether corrective work is needed, in-office or hospital-based operating facility, and combining multiple procedures (increasing concessions apply for multiple procedures).

    Although you may receive varying cost estimates from other practices, keep in mind that your surgeon’s education and training, plastic surgery board certification, his/her experience (at least 8 years of experience after residency is recommended), and the “X” factor of aesthetic artistry and surgical skill (i.e., talent) of your surgeon are important factors in pricing. Dr. Rad’s goal for every patient is to achieve nuanced and natural results with minimal recovery, and we have mechanisms in place to bring your goals in financial reach.

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