latest news

NEWS & EVENTS

Facial Profile Design

Paradigm Shift

Orthognathic, Maxillofacial, and Sleep Apnea Surgery

Devoting to the art and science of facial plastic surgery

What procedures do I need?

Beauty is the Promise of Happiness!?

By looking back at the last decade, orthognathic and maxillofacial surgery have experienced several huge changes of thoughts. Dr. Hsieh wanders how many doctors realize and willing to follow the change. However, the change itself is not the focal point as we (doctors) should catch up with the contemporary patient-centered treatment.
 

Office-Based Orthognathic Surgery

In the orthognathic center of Dr. Hsieh, anesthesiologist and surgeon will care jointly for a patient throughout the treatment. This is not applicable in any large-scale hospital where an experienced doctor has to operate or administer anesthesia to several patients at the same time. When an experienced doctor is away, less experienced doctor will take over the surgery or anesthesia. In some cases, it may be merely nurses who are responsible for the caring. In our center, every patient is exclusively cared by Dr. Hsieh with the anesthesiologist. Dr. Hsieh has had experience in both large-scale medical center and orthognathic center. Therefore, he insists to appoint the “same” anesthesiologist throughout the treatment in order for close administration of patient’s safety and prompt medication treatment. Every patient in our center has “high quality” anesthesia and surgery. Subsequently, unpleasant experience of post-anesthesia with nausea and vomiting can be greatly reduced or eliminated, which also extremely shorten the duration of hospitalization.

In the orthognathic center of Dr. Hsieh, a professional nurse will be assigned to every patient after surgery. The nurse will promptly provide patient with close observation and necessary care. On the contrary, nurses in large-scale hospital have to care for several patients (one-to-many caring) at the same time. Therefore, family members of patients are required to present at large-scale hospital. Since family members are not professional nurse, they might feel stressful caring for patient. Frequently, they cannot provide the accurate care and assistant to the patients.  

Surgery-First Approach

The concept of surgery-first is a face-oriented treatment. This type of treatment not only perfect the facial profile but also greatly shorten the overall treatment duration (including surgery and orthodontic). Therefore, treatment which originally lasts for 2-3 years can be shortened into 1 year or less. This concept is commonly adopted by all developed countries.

In the outdated treatment approach, the dentists only refer their patients to surgeon when the orthodontic treatment cannot correct maxillofacial deformities. This type of approach is a bite-oriented treatment. Outdated fallacy believes that accurate occlusion can fix facial profile. However, this is not the truth. Frequently, it will worsen the facial profile and further complicate the future treatment. 
 

Globalization's Impact

Via the internet, Dr.Hsieh has pre-diagnosed and arranged many foreigners for surgery in Taiwan. Many patients from different countries are treated by Dr. Hsieh and this is not commonly seen ten years ago. Nevertheless, we are thankful for the cooperation and assistant provided by orthodontists from foreign countries. If the foreign patients can visit Taiwan once every 2-3 month, they can consider for orthodontic treatment in Taiwan.
 

Computerized Surgical Planning

Generally, busy surgeons are not some of the most tech-savvy people. From many different perspectives, technology-assisted surgery has become an inevitable trend. Even busy surgeon like Dr. Hsieh had to spend time learning computer-assisted technology and apply it in the treatment to provide medical care which measures up to patients’ expectations.
 

Bi-jaw Surgery

In the 1980’s, western countries have agree on a common value in adopting two-jaw surgery for a better result. This is also the common treatment approach adopted by Dr. Hsieh. Unfortunately, there are still surgeons who prefer bite-oriented treatment and suggest one-jaw surgery to their patients which will only partially solve the issue.
 

Methods of Fixation

Currently, using plates and screws to fix the position of jawbone is the standard of care for orthognathic surgery. This type of fixation is chosen over maxillo-mandibular fixation (MMF) in which patients’ mouth is placed with wire fixation and immobilized for 6-8 weeks. However, Dr. Hsieh generally treats patients by proficiently applying plates and screws for fixation of orthognathic surgery. Therefore, patients can be given pureed food and practice mouth opening one week after surgery. Better oral hygiene and sufficient nutrition will greatly ease patients.
 

Combination Surgery

In most patients, most commonly adopted combined surgery by Dr. Hsieh is mandibular V-line bone reduction and alar reduction. Both of these surgeries when combined with orthognathic surgery can further upgrade the results. With the highest priority of anesthesia safety, patients can consider to incorporate other surgeries which require less surgical time such as rhinoplasty, zygomatic reduction or malar augmentation.
 

Facial Minor Adjustment

Orthognathic reduction surgery can often introduce huge changes to facial profile of an individual and achieve very satisfying results (to both patients and surgeon). However, the challenging task for surgeon is to administer facial reconstructive micro surgery through orthognathic reduction. Frequently, Dr. Hsieh will encounter patients who completed bite-oriented treatment and have no occlusion issue but are still unsatisfied of their facial profile. Therefore, Dr. Hsieh has to maintain the occlusion for facial reconstruction to meet the patients’ needs. Ten years ago, no one would imagine the ability of implementing facial reconstruction through orthognathic surgery.
 

Maxillofacial Surgery for Sleep-Disodered Breathing

On the other hand, patients with snoring and obstructive sleep apnea issues are a different group as compared to those who seek attractive facial profile. Dr. Hsieh cannot remove himself from this situation because he has discovered that according to the research in the past decade, maxillofacial surgery is a more effective surgical approach to expand respiratory airway comparing to removal of soft tissue (such as uvulopalatopharyngoplasty and glossectomy). However, most patients with issues in snoring and obstructive sleep apnea do not realize that orthognathic surgery approach has greater health benefits. 
 

Facial Feminization

Moreover, female and male naturally have distinctive facial features which originate from the differences in bone characteristics. Anthropologists are able to identify gender through the shape of human skull. Surprisingly, in our generation, Dr. Hsieh can use exquisite orthognathic facial sculpting surgery to alter the gender characteristics on human face and give a new life to those who need it.
 

Specialization

When you are choosing your surgeon, you can actually choose your own anesthesiologist-surgeon-orthodontist-dentist team. In order to achieve optimal integration with communication in the whole system, cosmetic surgery is definitely not the only important element. Do not assume that cosmetic surgeon has the same experience and ability to manage cutting of facial bone and repositioning it to the optimal location. This is similar in other fields and industries, most doctors only specialize in 2 or 3 fields but not mastering all from head to toe.