The Aesthetic Lower Face Analysis Diagnosis Selection of Surgical Procedures
A prominent mandibular angle that gives a squared face in Asians is considered unattractive as it imparts a coarse and masculine image. Mandibular contouring surgery allows slender oval faces.
“Angle reduction” is the old name of this procedure and a major misconception regarding what the surgery is for. The purpose of mandible reduction is to make the lower face appear slim in the frontal view and to have a smooth contour in the lateral view. Changing the mandibular plane and contouring the whole lower border of the mandible are critical steps. On the contrary, angle reduction with removal of triangular bone will inevitably leave an unnatural lower contour of mandible with secondary angle.
As shaping the lateral contour of the mandible alone may result in minimal improvement in the frontal view, surgical techniques to reduce the width of the lower face via narrowing genioplasty and sagittal resection of the lateral cortex should be combined.
Successful mandible reduction begins with careful preoperative preparation and planning. Three-dimensional analysis of the photographs and the radiographs in the frontal, sagittal, and transverse planes are important.
Examination of the shape and symmetry, the relationship between the maxilla and the mandible, overlying soft tissue contribution, and understanding the overall balance of the face are mandatory.
The ideal facial shapes may be different upon personal preference, as well as ethnic or cultural background. Especially when consulting patients with different national or ethnic backgrounds, careful attention should be paid during consultation for their ideal or desirable facial shape in mind.
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