Mandibular contouring: a surgical technique for the asymmetrical lower face

Correcting facial asymmetry is a difficult problem for plastic surgeons. From 1991 to 1996, the authors treated 53 cases of mandibular angle resection, 13 of which were of patients with an asymmetrical lower face. On the basis of these experiences, the authors highlight two important points in dealing with the asymmetrical lower face. The first is accurate resection of each side of the face. A cloth pattern was used to improve the accuracy of the procedure and to make the final result match the preoperative design regarding amount and shape. The second concerns soft-tissue change after the operation. Satisfactory results are obtained by the accurate resection of the bone coupled with the correct management of the surrounding soft tissue. The amount of bone to be resected was determined not simply by cephalometry, but by both cephalometry and external appearance. Postoperative cephalometry is not always symmetrical, and it is important that the final external appearance be harmonious and symmetrical. Using the above method, results have been satisfactory to both the surgeons and the patients, with the exception of three patients who had residual asymmetry. No permanent sensory loss or motor nerve palsy was observed, and no infections occurred.