Mandible Angle Resection
The angle of the mandible is at the lowest points under the earlobes. The excessive protrusion or outward expansion can form a square-shaped face. During the procedure, Dr. Chuang will make a 3–4-cm incision in the lower gum, subperiosteally detach the masseter muscle and other soft tissues from the mandible, and then, use a high-speed electric sawing system with an oscillating saw to resect and remove protrusive angles in a curvature alignment. The range of bone resection is approximately 2 cm anterior and posterior to the angles, and the average reduced thickness is 1–1.5 cm. Other uneven surfaces after bone resection can be smoothed out by the shaving osteotomy procedure to get a symmetric result on both sides. The goal of this procedure is softening and smoothing the jawline contour in the side view and removing the square-shaped angle protrusion; however, slimming the face in the front view alone has a limited effect, and the average reducible width on each side is only approximately 0.5 cm. Therefore, this surgery is suitable only for patients with mild to moderate protrusive angle of the mandible but not for those with severe square-shaped faces.
Surgical conditions
Duration
- Type of anesthesia: General anesthesia
- Type of incision: Intraoral lower gum (3–4 cm)
- Recovery: 5–7 days
- Removal of stitches: N/A
General instructions
No food and water on the day of surgery
- Only a soft or fluid diet should be consumed for 2 weeks postoperatively.
- Extensive opening of mouth or consumption of very hard food and fruits should be avoided for 1 month postoperatively.
- Force on the face or squeezing of the face should be avoided for 3 months postoperatively.
- Over-chewing should be avoided during eating to prevent hyperosteogeny or bone regrowth.
Ideal candidates
- Those with a mild to moderate square-shaped or wide faces.
- Those with normal face widths but obviously protrusive angles in the side view.
- Those whose mandible angles seem obviously protrusive due to long-term injection of botulinum toxin for masseter muscle hypertrophy.
- Those who want to change the manly facial characteristics of excessively protrusive mandible angles.
- Those whose face slimming result by botulinum toxin injection is unobvious.
Potential complications
- Temporary chin numbness
- Asymmetric mouth movement
- Hematoma
- Bone regrowth
- Over-correction
Surgical advantages
-
Will soften the facial contour in the side view without slimming the face very much.
-
The surgical field is only adjacent to the angles, and postoperative recovery is fast.
-
Spontaneous masseter muscle atrophy can occur, and botulinum toxin injection is not required in the future.
-
Will partially improve depressed cheeks.
Surgical drawbacks
-
The chin and mouth can have temporary numbness or sensation disturbance.
-
The face slimming result in the front view is unobvious; the result is limited for patients with severe mandible protrusion.
-
Only the mandible angle is cut off; thus, partial bone re-growth is possible in the future.
-
Over-cutting can cause an acute (sharp face) or a depressed jawline contour.
