Endoscopic-Assisted Intraoral Three-Dimensional Reduction Mandibuloplasty

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Reconstructive Surgery

Background:

• Prominent mandibular angles are common in Oriental populations, often perceived as masculine and aesthetically undesirable.
• Traditional intraoral reduction mandibuloplasty can lead to inaccurate ostectomies and complications due to limited visibility.
• A need exists for improved surgical techniques to achieve predictable and aesthetically pleasing mandibular contouring.

Purpose of the Study:

• To evaluate the efficacy and safety of a one-stage, long-curved ostectomy combined with splitting corticectomy using endoscopic assistance for reduction mandibuloplasty.
• To assess the aesthetic outcomes and patient satisfaction with this minimally invasive intraoral approach.

Main Methods:

• A total of 112 patients underwent one-stage long-curved ostectomy and splitting corticectomy via an intraoral approach with endoscopic assistance.
• The procedure involved marking the ostectomy line and performing the osteotomy and corticectomy under direct vision using an oscillating saw.
• A specialized retractor with an adjustable endoscope provided a clear operative field.

Main Results:

• The technique resulted in 3-dimensionally refined mandibular contouring, reducing lower face width and creating natural-looking mandibular angles.
• Patients reported high satisfaction with both frontal and lateral facial appearances.
• Significant increases in the gonial and mandibular plane angles were observed, with no major complications like fractures or facial nerve injury.

Conclusions:

• Endoscopic assistance enables accurate, safe, and reproducible intraoral reduction mandibuloplasty.
• The combined technique effectively recontours the mandible for a thinner frontal appearance and natural lateral profile.
• This approach offers a reliable method for achieving desirable aesthetic outcomes in mandibular angle reduction.