Mandibular angle reduction versus mandible reduction

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Aesthetic Surgery

Background:

• Current terminology like "mandibular angle reduction" and "reduction angleplasty" implies surgery is limited to the mandibular angle.
• Patients frequently report noticeable lateral facial changes but minimal frontal changes after these procedures.
• This discrepancy arises from surgical techniques focusing on curved ostectomy at the mandibular angle, neglecting broader facial contouring.

Purpose of the Study:

• To propose revised terminology for facial width reduction surgeries.
• To advocate for surgical techniques addressing a larger area of the mandible for improved frontal aesthetic results.
• To highlight effective surgical methods for achieving desired facial contouring.

Main Methods:

• Analysis of patient outcomes and common complaints following mandibular angle reduction surgeries.
• Evaluation of surgical techniques and their impact on lateral versus frontal facial appearance.
• Review of anatomical considerations for achieving significant facial width reduction.

Main Results:

• Operations limited to the mandibular angle often fail to meet patient expectations for frontal facial changes.
• Resection of the outer cortex, particularly using a reciprocating saw (corticectomy), is effective for significant lateral flaring reduction.
• A broader surgical approach beyond just the mandibular angle is necessary for comprehensive facial width reduction.

Conclusions:

• The terms "mandibular angle reduction" and "reduction angleplasty" are potentially misleading.
• Renaming these procedures to "mandible reduction" and "reduction mandibuloplasty" would more accurately represent the required surgical scope.
• Corticectomy with a reciprocating saw is a safe and efficient technique for maximizing mandibular width reduction.