Surgical designs and techniques for mandibular contouring based on categorisation of square face with low gonial...

In East Asian population, a square face is considered unappealing as it imparts a coarse and masculine look. Therefore, Oriental women prefer to have an ovoid and slender facial contour, which is thought to be more feminine and attractive. Nowadays, mandibular contouring surgery has become a commonly performed procedure. Clinical data show that majority of patients who have severe form are characterised by a definite square-shaped face with low gonial angle. A square face is usually visualised in frontal view but the lateral view provides additional information regarding gonial angle, mandibular plane steepness, chin deficiency and more importantly, length of the ramus. These factors are the key points for a precise categorisation, design, selection of surgical methods and choosing the ostectomy line for contouring on a square face with low angle.

From 2005 to 2009, 94 women were diagnosed as square face with low angle. Three types of surgical design based on procedures such as mandibular 'V-Line' ostectomy, mandibular outer cortex split ostectomy, sliding genioplasty and inlay bone graft in various combinations were constructed, depending upon the presenting facial features.

Precise categorisation, designs and techniques resulted in higher satisfaction as these procedures provided an overall narrowing and harmonising effect on the lower facial contour postoperatively.

Patients with square face and low gonial angle come with multitude of features so that design and technique applied should be tailored to each individual to achieve perfection.