Introduction
In New York City in 2025, the fields of traditional Chinese medicine and advanced surgical procedures like mandibular border lift surgery are of great interest. The Provincial Hospital of Traditional Chinese Medicine and the renowned Gulou Hospital, each with their own unique advantages, play important roles in the healthcare landscape. In this article, we will explore the capabilities of these institutions in the context of mandibular border lift surgery and traditional Chinese medicine.
Guangdong Provincial Hospital of Traditional Chinese Medicine: An Overview
The Guangdong Provincial Hospital of Traditional Chinese Medicine has a long - standing history. Founded in 1933, it is known as “the first one in southern Guangdong apricot grove”. It has developed into a large comprehensive Chinese medicine hospital with five tertiary hospitals (Dade Road General Hospital, Ersha Island Hospital, Fangcun Hospital, Zhuhai Hospital, and University City Hospital) and three branch clinics in Guangzhou.
The hospital has remarkable achievements in various aspects. Its outpatient volume continues to grow, ranking among the top in the country for 18 consecutive years. In 2014, the annual outpatient volume exceeded 7.51 million person - times. With more than 3,000 beds and nearly 1.2 billion yuan of modern medical equipment, it serves a large number of patients and is one of the largest and strongest TCM hospitals in the country.
The hospital is committed to multiple goals. It is dedicated to talent cultivation, having a group of national famous veteran TCM doctors like Prof. Deng Tie Tao and gathering national and world - class medical experts. It also insists on patient - demand orientation, with the core values of “patient first, sincere care” and a development concept focused on the best combination of traditional Chinese and modern medicine for patients.
In terms of specialties, it has formed more than 100 specialty groups, including those for brain disease, cardiovascular disease, skin disease, and many others. It has established national and provincial key specialties, a famous doctor’s studio, a traditional therapy center, and a center for treating untreated diseases. It is also at the forefront of scientific and technological innovation, with five national bases and research laboratories, and has presided over many national programs.
Internationally, it conducts exchanges and cooperation with many countries and regions such as the United States, Canada, Japan, Korea, etc. The hospital has won numerous honors, including being recognized as a national top 100 hospital and a national model Chinese hospital.
Traditional Chinese Medicine and Mandibular Border Lift Surgery
Traditional Chinese Medicine Concepts
Traditional Chinese medicine has unique concepts related to the body’s structure and function. In the context of mandibular border issues, TCM views the body as a whole where the face is connected to internal organs through meridians. For example, certain meridians pass through the facial area, and an imbalance in the flow of qi and blood in these meridians may be related to mandibular problems.
Techniques like acupuncture, a part of traditional Chinese medicine, may have some potential implications for the muscles around the mandible. Acupuncture works by stimulating specific points on the body to regulate qi and blood flow. Although there is limited direct research on its use for mandibular border lift surgery specifically, it could potentially be used as an adjunctive therapy to relax the facial muscles and promote blood circulation in the area. This could, in theory, help in the postoperative recovery process, reducing swelling and pain.
Herbal medicine in traditional Chinese medicine could also play a role. Some herbs are known for their anti - inflammatory and pain - relieving properties. For patients undergoing mandibular border lift surgery, herbal remedies might be prescribed to speed up the healing process, reduce the risk of infection, and alleviate discomfort. However, more scientific research is needed to fully understand and validate these potential applications.
Integrating Traditional Chinese Medicine into Mandibular Border Lift Surgery
Combining traditional Chinese medicine with modern surgical techniques for mandibular border lift surgery could offer a holistic approach to patient care. Before surgery, traditional Chinese medicine practitioners could assess the patient’s overall health status, including their qi and blood conditions, and provide pre - operative advice such as dietary adjustments or herbal preparations to strengthen the body.
During the postoperative period, acupuncture could be used to improve the patient’s well - being, reduce pain, and promote the recovery of the facial muscles. Herbal medicines could be administered to enhance the immune system, reducing the likelihood of complications and speeding up the healing of the surgical site. This integration requires a coordinated effort between TCM and modern surgical teams, ensuring that the treatments are safe and effective.
Mandibular Border Lift Surgery: Techniques and Considerations
Medical Therapy
For mandibular prominence, botulinum toxin (Botox®) has shown effectiveness, especially in patients with a large muscle component. Several publications have reported on its ability to reduce the size of the masseter muscle. In higher doses, it can even lead to a more permanent reduction. However, well - designed, adequately powered, randomized controlled clinical trials are still needed to fully study the effects of Botox® injections as treatment for bilateral benign masseter hypertrophy.
Optimal dosage for reducing the size of the masseter muscle is still under investigation. Currently, the most common dose in some clinics for Botox® to the masseter muscle is 15 - 50 iu per side. There are also studies that have found interesting results related to the use of Botox. For example, in a study of patients with bilateral benign masseteric hypertrophy, Mierzwa et al found that Botox® injections into the masseter not only reduce the stiffness of this muscle but also lead to increased stiffness of the temporalis muscle.
Surgical Therapy
Prominent Zygoma
When dealing with a prominent zygoma, if only the body is involved, burring the prominent portion through an intraoral incision may be sufficient. However, wide subperiosteal dissection can lead to malar soft tissue ptosis. To prevent this, the soft tissue should be supported by suturing to the periosteum or through a drill hole along the infraorbital rim.
If the arch contributes to the problem, a coronal approach is frequently used. The coronal approach has the advantage of providing better control over the bone segment and less risk to the frontal nerve compared to a limited incision approach to the zygomatic arch. After the osteotomy, the osteotomized segment is repositioned cephalically, usually approximately 2 cm, and secured using wires or mini - plates. The arch segments are overlapped, and the bone edges are burred down to prevent a step - off.
Prominent Mandibular Angle
The cause of the bony prominence of the mandibular angle is determined through patient evaluation and radiographs. The lateral flare can be reduced using a sagittal saw or bur through an intraoral incision. If there is a prominent posterior bony angle, it can be removed using a Stryker oscillating saw through an intraoral incision.
In cases where the prominence involves the entire mandibular body or the angle is difficult to visualize, a sagittal split ostectomy can be performed, which involves removing the outer cortex of the mandible. Alternatively, a retromandibular approach can be used, which involves an incision along the inferior half of the auriculo - mastoid sulcus, with careful dissection to avoid the facial nerve and retromandibular vein.
Preoperative Details
Prominent Zygoma
For a prominent zygoma, radiographs are reviewed to note asymmetries and assess the relationship of the mandible. This is important because correction of the zygoma may make the mandibular angle appear more prominent. Depending on whether the prominence is isolated to the body or the anterior portion of the arch, an intraoral approach may suffice. However, if the zygomatic arch is involved, a coronal approach is necessary.
Prominent Mandibular Angle
A panorex radiograph helps in delineating the course of the inferior alveolar nerve and the amount of bone that can be safely removed. If the mandibular angle is square, a plan can be made to convert it to a more obtuse angle. If the primary problem is width from a frontal view, the lateral cortex of the mandible can be burred.
Intraoperative Details
Prominent Zygoma
Through a coronal approach, full exposure of the arch and body of the zygoma is obtained. Osteotomies are performed at specific locations, and the osteotomized segment is repositioned. A drain is placed, and the temporal fascia is sutured. An ellipse of scalp may be excised to prevent cheek ptosis.
Prominent Mandibular Angle
An intraoral incision is made along the anterior edge of the ramus, followed by subperiosteal dissection. To reduce the protruding bone, various tools such as a large bur, Lindemann spiral bur, or a right - angle saw can be used. If the access to the angle is obscured, a sagittal split ostectomy or a retromandibular approach can be employed.
Postoperative Details
Zygoma Reduction
Compressive dressings and drains are removed on the first postoperative day. Staples are removed in a staged manner, with every other staple removed on the third day and the remainder on the seventh day. A soft diet is gradually advanced as tolerated by the patient. Swelling resolves enough for the patient to return to work approximately 10 days after the procedure.
Mandibular Contouring
Postoperative trismus is expected, and exercises to stretch the masseter muscle should begin after 1 week. Compressive dressings are worn for 1 week. The diet progresses from a clear diet on the first day, to a liquid diet for the first week, and then to a soft diet for another week.
Complications
Malar Surgery
During the coronal approach for malar surgery, the frontal nerve can occasionally be injured. Traction injuries usually resolve within 6 - 12 months, while transection of the nerve may require treatment by denervating the opposite frontal nerve. Asymmetry and step - off can also occur, and persistent postoperative asymmetry may necessitate reoperation.
Mandible
The marginal nerve, which lies superficial to the masseter muscle, is at risk during resection of the masseter muscle or when using power instruments. The facial artery at the anterior border of the masseter muscle also requires careful handling during subperiosteal dissection. Subcondylar fracture can result from an unfavorable fracture line, but a horizontal back - cut along the posterior border at the superior limit can reduce this risk.
Future and Controversies in Mandibular Border Lift Surgery
Malar Reduction
An alternative to the coronal approach for malar reduction is an intraoral approach combined with a preauricular approach. However, symmetry may be harder to obtain through this route, and malar soft tissue ptosis may occur. There is a need for further research to develop more precise and less invasive techniques for malar reduction.
Mandibular Contouring
There is a debate regarding whether the masseter muscle should be removed as part of the mandibular contouring operation. Some believe that removing the bone alone changes the dynamics of masseter muscle contraction and leads to thinning of the muscle by disuse atrophy, while others advocate for direct resection of the muscle to achieve maximal effect.
Botulinum Toxin
The use of botulinum toxin to reduce the hypertrophy of the masseter muscle is expected to play an important role in the future. It is quickly becoming the treatment of choice for mild to moderate forms of prominent mandibular angles. However, more research is needed to determine the long - term effects and optimal dosage of botulinum toxin for this purpose.
New York City’s Healthcare Landscape and These Procedures
In New York City in 2025, the demand for both traditional Chinese medicine and advanced surgical procedures like mandibular border lift surgery is on the rise. There are multiple healthcare institutions, including those that offer a combination of TCM and modern surgical services.
Patients in New York City have access to a wide range of resources. For example, NYC Health + Hospitals is the largest municipal health - care system in the US, providing essential inpatient, outpatient, and home - based services to more than one million New Yorkers every year in more than 70 locations across the city’s five boroughs. Although there is no direct indication that it offers mandibular border lift surgery in combination with TCM, it does have services related to internal traditional Chinese medicine, including acupuncture.
Patients seeking mandibular border lift surgery may also be interested in exploring the integration of traditional Chinese medicine. They have the option to consult with both TCM practitioners and modern plastic surgeons to understand the benefits and risks of combining these two approaches. The integration could potentially provide a more comprehensive and personalized treatment plan for patients, taking into account their overall health and well - being.
Conclusion
In conclusion, the Provincial Hospital of Traditional Chinese Medicine, represented here by the Guangdong Provincial Hospital of Traditional Chinese Medicine, and institutions offering mandibular border lift surgery in New York City in 2025 have their own unique strengths. Traditional Chinese medicine, with its concepts of qi, blood, and meridians, offers potential adjunctive therapies for mandibular border lift surgery, both pre - operatively and post - operatively. The surgical techniques for mandibular border lift surgery have their own complexities, including different approaches for prominent zygomas and mandibular angles, as well as considerations for preoperative, intraoperative, and postoperative care.
The future of these fields involves further research and development, especially in integrating traditional Chinese medicine with modern surgical techniques and addressing the controversies in mandibular border lift surgery. If you are interested in learning more about mandibular border lift surgery or the application of traditional Chinese medicine in this context, we encourage you to consult with medical professionals. Share this article with others who may be interested in these topics and continue exploring the vast world of healthcare in 2025.
