Standardization of surgical techniques used in facial bone contouring

Since the introduction of facial bone contouring surgery for cosmetic purposes, various surgical methods have been used to improve the aesthetics of facial contours. In general, by standardizing the surgical techniques, it is possible to decrease complication rates and achieve more predictable surgical outcomes, thereby increasing patient satisfaction. The technical strategies used by the author to standardize facial bone contouring procedures are introduced here. The author uses various pre-manufactured surgical tools and hardware for facial bone contouring. During a reduction malarplasty or genioplasty procedure, double-bladed reciprocating saws and pre-bent titanium plates customized for the zygomatic body, arch and chin are used. Various guarded oscillating saws are used for mandibular angloplasty. The use of double-bladed saws and pre-bent plates to perform reduction malarplasty reduces the chances of post-operative asymmetry or under- or overcorrection of the zygoma contours due to technical faults. Inferior alveolar nerve injury and post-operative jawline asymmetry or irregularity can be reduced by using a guarded saw during mandibular angloplasty. For genioplasty, final placement of the chin in accordance with preoperative quantitative analysis can be easily performed with pre-bent plates, and a double-bladed saw allows more procedural accuracy during osteotomies. Efforts by the surgeon to avoid unintentional faults are key to achieving satisfactory results and reducing the incidence of complications. The surgical techniques described in this study in conjunction with various in-house surgical tools and modified hardware can be used to standardize techniques to achieve aesthetically gratifying outcomes.