The Standard Mandible Reduction with Intraoral Approach

  • Sanghoon Park


  1. 1.

    For precise surgical planning and prevention of postoperative asymmetry, three-dimensional analysis of the photographs and the radiographs in the frontal, sagittal, and transverse planes is important.

  2. 2.

    The inferior alveolar nerve is the most important structure during mandible reduction, and it should be carefully examined preoperatively in panoramic view as well as in a computed tomography (CT) scan.

  3. 3.

    The superior limit for resection is the occlusal plane; the anterior limit is the convergence of the mandibular oblique line with the lower mandibular border and mental nerve.

  4. 4.

    The resected segment typically has an elongated semilunar shape instead of being triangular; when removed, it leaves a gently curved lower mandibular border.

  5. 5.

    If an osteotomy is too straight and fails to form a smooth transition, it will leave a “secondary angle.” The secondary angle can be palpated or sticks out externally. If secondary angle is obvious, it may require burring or additional osteotomy.

  6. 6.

    In cases of an inward-curled angle with a convex transverse shape, sagittal resection of the body is required to reduce the width of the mandible more effectively.



  1. 1.
    Baek SM, Kim SS, Bindiger A. The prominent mandibular angle: preoperative management, operative technique, and results in 42 patients. Plast Reconstr Surg. 1989;83(2):272–80.CrossRefPubMedGoogle Scholar
  2. 2.
    Yang DB, Park CG. Mandibular contouring surgery for purely aesthetic reasons. Aesthet Plast Surg. 1991;15(1):53–60.CrossRefGoogle Scholar
  3. 3.
    Adams WM. Bilateral hypertrophy of the masseter muscle; an operation for correction; case report. Br J Plast Surg. 1949;2(2):78–81.PubMedGoogle Scholar
  4. 4.
    Deguchi M, Iio Y, Kobayashi K, Shirakabe T. Angle-splitting ostectomy for reducing the width of the lower face. Plast Reconstr Surg. 1997;99(7):1831–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Han K, Kim J. Reduction mandibuloplasty: ostectomy of the lateral cortex around the mandibular angle. J Craniofac Surg. 2001;12(4):314–25.CrossRefPubMedGoogle Scholar
  6. 6.
    Hwang K, Lee DK, Lee WJ, Chung IH, Lee SI. A split ostectomy of mandibular body and angle reduction. J Craniofac Surg. 2004;15(2):341–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Lee TS. Standardization of surgical techniques used in facial bone contouring. J Plast Reconstr Aesthet Surg. 2015;68:1694–700.CrossRefPubMedGoogle Scholar
  8. 8.
    Neligan PC. Principles. In: Neligan PC, editor. Plastic surgery, vol. 1. 3rd ed. Seattle: Elesevier Saunders; 2012. p. 179–83.Google Scholar
  9. 9.
    Lo LJ, Wong FH, Chen YR. The position of the inferior alveolar nerve at the mandibular angle: an anatomic consideration for aesthetic mandibular angle reduction. Ann Plast Surg. 2004;53(1):50–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Salmerón-Escobar JI, del Amo-Fernández de Velasco A. Antibiotic prophylaxis in Oral and Maxillofacial Surgery. Med Oral Patol Oral Cir Bucal. 2006;11(3):E293.Google Scholar
  11. 11.
    Morris DE, Moaveni Z, Lo LJ. Aesthetic facial skeletal contouring in the Asian patient. Clin Plast Surg. 2007;34(3):547–56.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Center for Facial Bone Surgery, Department of Plastic SurgeryID HospitalSeoulSouth Korea

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