Mandibular angle ostectomy for Chinese women: approaches and extent determined by cephalometric analysis

Giving a square and muscular appearance, a prominent mandibular angle is considered to be unattractive in the Orient. Because of the different aesthetic sensitivities, the problem is reported more frequently in the Orient than that in the West. In most reports, the final choice of surgical procedure, including the approach, position of ostectomy, and volume of bone to be cut, depended subjectively on the experience of the surgeon and the desire of the patient. This article provides a study to make the surgical procedure accurately and objectively, involving 46 female patients asking for reduction of prominent mandibular angle for cosmetic reasons. Measurement and analysis of cephalometric radiographs were performed preoperatively. According to the different characteristics of the prominent mandibular angle in front and lateral views of the radiographs, the patients were classified into 4 types. In each type, ostectomy of different extent via different approaches or masseter botulinum toxin A injection only was given. Postoperative cephalometric analysis was also made to evaluate the result objectively. The results have been generally satisfactory.