Combining Two Jaw Orthognathic Surgery with Facial Bone Contouring Surgery to Obtain Balanced Proportions of the Face in Asians

Introduction:

Conventional orthognathic surgery improves the lateral facial profile of a patient by correcting the relative position of the upper and lower jaws in prognathic and retrognathic patients. In the recent years, orthognathic surgery has evolved to be a very powerful tool in achieving facial attractiveness and has formed a relatively new field of cosmetic surgery in aesthetic two jaw surgery. Facial bone contouring surgery of the mandible and zygoma has also become a powerful tool in achieving an attractive face by improving the proportions of the facial skeleton mainly from the frontal view, compared to the profile improvement of the two jaw surgery. By combining orthognathic surgery and facial bone contouring surgery in a one stage operation, the authors have achieved balanced proportions of the face in the lateral view as well as the frontal and quarter views.

Methods:

Between December 2010 and January 2013, 321 patients aged between 17 and 51 years underwent two jaw orthognathic surgery and facial bone contouring surgery at Regen Plastic Surgery. Patients constituted of 206 women and 115 men, and nationality of the patients was Korean, Chinese, Vietnamese and Japanese.

 

 

Results:

Majority of the patients had class III skeletal features with wide, broad and flat facial contours. Two jaw orthognathic surgery was performed for correcting skeletal discrepancies of the upper and lower jaws as well as the asymmetry of the jaws caused by the cant and yaw. Concomitant mandibuloplasty including genioplasty was performed in 296 patients and malarplasty was performed in 92 patients. A clockwise rotation of the upper and lower jaws improved the lateral facial profile as well as aid in reducing the size of the lower face. Concomitant mandibuloplasty achieved a small and narrow jaw line enhancing the facial proportions to achieve a youthful appearance. Also malarplasty improved the contour of the midface by reshaping the flat midface to a more cubic form and reducing the laterally protruding malar prominence to a smoother shape.

Conclusions:

The combination of two jaw surgery, mandibuloplasty and malarplasty is a very powerful tool to change the facial proportions in both the profile and frontal views which achieves a balanaced attractive face in Asians.