Essential Surgical Anatomy for Facial Bone Contouring Surgery

Abstract

• 1. In this chapter, reader can be reminded of the essential anatomy that should be respected when performing facial bone contouring surgery.

• 2. Inferior alveolar nerve is the most important anatomic structure during mandible reduction surgery. Because the course is variable by individuals, surgeon should keep in mind the entire course before and during mandible reduction surgery.

• 3. Infraorbital nerve is the most important nerve in midfacial region during malar reduction or augmentation surgeries. Therefore surgeon should check the location of infraorbital foramen before surgery and pay attention in order not to irritate the nerve during surgery

• 4. Facial nerve palsy after facial bone contouring surgery is uncommon, but it can cause significant, persistent symptoms. The temporal branch and the marginal mandibular branch are the most vulnerable branches during facial bone contouring surgery. Thus, surgeon should be cautious in dangerous zones.

• 5. Major vessels such as facial artery, vein, and retromandibular vein could be damaged during mandible reduction surgery. It leads to profuse bleeding which cannot be controlled easily by electrocauterization. Therefore, prevention is the best way for these major vessel injuries.

• 6. Because mentalis muscle is the only elevator of the lower lip and chin, it must be carefully reattached after anterior vestibular approach. If this muscle is not properly repositioned during closure, the chin will droop and the lower lip will take on a sagging appearance.