Facial Bone Reduction Surgery & Orthognathic Surgery - 謝明吉、姜厚任顎顏面美學重建專科診所-風華整形聯合診所

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Facial Bone Reduction Surgery & Orthognathic Surgery

Just like other values; as we live in the global village with gradually close distance among human beings, standard of beauty also progressively differ among different parts of the world. In the Eastern society, we strive for gentle facial contour and small face which equals to the size of a palm.

Both the facial bone reduction and orthognathic surgery are facial plastic surgery involving intraoral incisions. From the perspective of surgical execution, these two surgeries are completely different surgery. However, the diagnosis and demand for these different surgeries are frequently being confused by the general public and even the professionals.

On the other hand, both the orthognathic and bone reduction surgeries focus on sculpting a smoother facial contour. In most cases, coupling of these two surgeries is required to obtain the best result. For instance, the best treatment approach for big round face with underbite facial profile (protruding upper and lower jawbone) and prominent maxilla or mandible is to receive maxilla-mandible setback surgery, hence correcting the issue with protruding jawbone. At the same time, the bone reduction surgery is performed on the same incisions (orthognathic and bone reduction surgery share the same incision, while mandibular surgery and mandible reduction surgery share the same incision). When necessary, genioplasty can be combined and performed concurrently. In summary, lateral contour (underbite and protruding facial profile) can be sculptured by orthognathic surgery and genioplasty, and anterior contour (big round facial profile) can be improved by bone reduction surgery.

Most of the patients who come to seek for our consultation have underwent bone reduction surgery but are not satisfied with the post-surgical facial profile. This is because there are no improvement to the lateral contour (including nose, upper lip, lower lip, and chin line). If you want to know the approximate contour after bone reduction, you can perform some simple tests. For instance, you can stand in front of a mirror and cover the outer range of your face with both of your hands. Besides, you can use graphic-editing software to erase the outer range of your face on your photo. Subsequently, you can roughly simulate your appearance after bone reduction. If you like the look, your satisfaction after receiving bone reduction is likely higher. However, if you are still unsatisfied with your simulated face, it is possible that your issue is orthognathic but not bone reduction, or you may need to couple orthognathic with bone reduction surgery. Although the size of the face is reduced with bone reduction alone, occasionally the structure of teeth and jaw will become more prominent and apparent.

As previously mentioned, facial bone reduction and orthognathic surgeries are facial plastic surgery with intraoral incisions. A recovery period of approximately 1-2 weeks is required either of these surgeries. Therefore, the best solution for correcting contour issue with facial bone (regardless of orthognathic or bone reduction) is to complete all treatments at the same time. Otherwise, the second surgery has to be performed at a different time point but at the same area of incision. Furthermore, the recovery period will be a longer and unacceptable process for the patients.

In addition, professionals are often confused with some facial profiles such as underbite – typical characteristics including lack of fullness with mid-face (two sides of the nose below the eyes), relatively protruding mandible, loose facial expressions, and solemn face. However, this type of underbite facial profile “does not” represent underbite of the teeth (malocclusion with lower teeth in front of upper teeth). In other words, some people with underbite facial profile actually have normal dental occlusion but relatively protruding lower jaw from the perspective of bone alignment, which we refer as skeletal class III. Most “professionals” would eliminate the issue with jawbone when they notice normal dental occlusion and suggest the patients to receive bone reduction surgery. However, bone reduction will only reduce the size of face but the characteristic of “moon-shaped” face with skeletal class III still exist. Frequently, the real need for this type of underbite facial profile is orthognathic surgery (or coupled bone reduction) to setback the protruding jawbone, but not bone reduction alone.

In summary, orthognathic coupled bone reduction surgery is a 3-D improvement for issues with “protruding jawbone” and “oversized face”. For those who want to sculpt a smooth and small contour, this approach is currently the maxillofacial plastic surgery with the most optimal result.