Mandibular angle osteotomy in Asian patients: A narrative review on techniques, emerging technologies, and...

Mandibular angle osteotomy (MAO) is widely performed in East Asian patients seeking lower-face contouring. Although numerous osteotomy designs and adjunctive technologies have been described, practical guidance for selecting an appropriate technique according to mandibular morphology, surgical endpoints, and surgeon experience remains limited.

A narrative review was conducted using a systematic literature search of PubMed and Embase up to December 30, 2025. Studies related to MAO techniques, anatomical classification, aesthetic assessment, adjunctive procedures, emerging technologies, complications, and long-term remodeling were reviewed.

MAO techniques differ mainly in the starting point, endpoint, and trajectory of the osteotomy line. Long curved osteotomy remains a commonly used approach for prominent mandibular angles, whereas ABC osteotomy, U-shaped osteotomy, V-line osteotomy, mandibular outer cortex reduction, mandibular body osteotomy, genioplasty, and partial masseter muscle resection may be selected according to specific skeletal and soft-tissue features. Surgical endpoints should include not only skeletal reduction but also frontal width, lateral contour, mandibular border smoothness, symmetry, soft-tissue support, neurosensory safety, patient satisfaction, and long-term remodeling. Digital planning, osteotomy templates, navigation, and endoscopic assistance may improve accuracy and safety, especially in anatomically complex cases.

MAO should be planned as an individualized lower-face contouring procedure rather than a uniform reduction technique. A morphology-based decision-making framework may help clarify indications, optimize surgical endpoints, reduce complications, and improve long-term aesthetic outcomes. Future studies should emphasize standardized outcome measures, patient-reported outcomes, and long-term three-dimensional assessment.

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