Lower Jaw Osteotomy/Square Face Reduction Surgery
Before proceeding with the surgery, the cause of a square face derives from the bulking of the bite muscles should be eliminated. The patient may have the bulking of bite muscle combines with lower jaw expansion. If the square face results from the bulking of bite muscle then a simple botox injection should be suffice. However, if it involves bony expansion then the fundamentally improvement on the condition with osteotomy cannot be avoided. For the case of combined bony expansion with bulking bite muscle, the bony expansion would be improved by appropriate osteotomy. The bulking muscle should have also reduced its size after the surgery.
Case 1 Dr. Hsieh's recommendation for square faced patient is often to perform the lower jaw osteotomy. The face should look natural after the osteotomy. If looked directly at the patient's anterior face, the lower face should have been reduced and narrowed (This transformation should be noticeable not just from the lateral side look), the lines at the corner of the lower jaw should have a soft finishing (retaining part of the natural curve of the bone) without steep and sharp edges (looks unnatural), these are especially important for patient with elongated face. This young lady had broad forehead, long nose and chin, so when performing the osteotomy, the bones cannot be cut too steeply. She received the lower jaw osteotomy and nose augmentation. The outcome was compared 6 weeks after the surgery.
Case 2 This patent received "via skin-lower jaw osteotomy" from other surgery. The patient is dissatisfied with the final appearance of the surgical outcome where it's overly steep and sharp while looks unnatural. Dr. Hsieh conducts through the facilitation of 3D computer diagnostic software to reconstruct a more natural looking lower jaw bone edges that give better facial profile to the patient. (Myth: Many surgeons still believe that lower jaw osteotomy is the simple procedure to cut the lower jaw edges. The Truth: After cutting the lower jaw edges the mid- and lower-facial areas will not be reduced or narrowed. The cutting of edges only has effect on the saggittal view of the face and hence the name of saggittal split) Most individual want the anterior facial area reductions as long as the lower jaw edges appear with soft and natural contouring lines, which is the result of vertical split combined with conservative saggittal split.
Case 3 When the lower jaw expanded outwardly, a person will end up with a squared face shape or a home plate face shape. This would increase facial area and the person's appearance would seem to lack sophistication on his/her facial features. It takes away your features' persona while quietly taken away your proclivity. Sometimes, most people associated the protruded jaw bones with long term betel nut chewing. This young man had medium square face. After received vertical osteotomy on large areas, this patient's anterior facial area is greatly reduced; in addition, medium range horizontal osteotomy was also performed so that the original 90 degree squarish jaw lines are now inclined to the normal 120 to 140 degrees. The 3D osteotomy on the patient's lower jaws made his charming self stood out with now sophisticated facial features.
Case 4 This young already has pointy chin and delicate facial features, however the anterior view of the face indicated that the face was too elongated while the chin carried backward to the edge of the lateral lower jaws with overly angled V-line. The lateral lower jaw edges showed almost 90 degree turns. Based on the 3computer imaging analysis result, the treatment plan included large area vertical and saggittal osteotomies to create a softer facial feature lines. Dr. Hsieh often observed that patients received osteotomy or orthognathic surgery had attained attractive and improved proclivities after the surgeries.
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All Written Contents and Pictures Created by Dr. Adrian M. Hsieh and Dr. Scott H. Jiang
Aesthetic Medicine Department Plastic Surgery DepartmentAesthetic Dentistry Department
Results of surgery vary among patients. Please consult your doctor.