Analysis of incidences and types of complications in mandibular angle ostectomy in Koreans

A prominent mandibular angle is considered to be unattractive in Asians because it gives the face a square, coarse, and muscular appearance. Asian women desire to have an ovoid, reduced, and slender face by aesthetic mandibular angle resection. Mandibular angle ostectomy has been known to be effective and to satisfy both surgeons and patients. Especially in Korea, it has become as popular as facial bone contouring surgery, which reduces lower facial width. However, a narrow surgical field hinders direct view of the site, making a procedure that is rather difficult to perform. Despite thorough presurgical planning and attention, there can be many complications and unfavorable results. The purpose of this study is to find out the cause of these complications of mandibular angle ostectomy and to develop methods that could prevent these complications from occurring. A questionnaire consisting of 30 questions regarding mandibular angle ostectomy was sent to 40 Korean plastic surgeons. Data from 33 surgeons were analyzed. The total number of operations was 1251, and among them complications appeared in 124 operations, a complication rate of 9.9%. In regards to severe complications, there were 8 cases of subcondyle fracture of the mandible and 6 cases of severe bleeding. Transient facial nerve injury, infection, trismus, asymmetry, undercorrection, overcorrection, secondary angle formation, and entrapped bony segment were also noted as complications. We will report the cause and the prevention methods for each complication.