Mandibular symphyseal contouring in mild mandibular prognathism

Kölle's mandibular segmental osteotomy, with extraction of the bilateral first bicuspids, is often used in cases of mild mandibular prognathism. While mandibular prognathism is usually corrected by mandibular ramus osteotomy and the mandible is set back en bloc, the premolar region alone is set back by segmental osteotomy, retaining the protruding mental area. In Asians, particularly, the protruding chin is not preferred by our concepts of beauty. In mandibular segmental osteotomy, the entire mandibular symphyseal shape should be considered. Mandibular symphyseal contouring constitutes setting back the premolar region by segmental osteotomy, recession genioplasty, and chiseling out the protruding middle portion of the protruding chin. In 18 series of mild manibular prognathism in Asians patients, this procedure was used and satisfactory aesthetic results were obtained.