Mandibular contouring surgery by angular contouring combined with genioplasty in orientals

A square mandible is often indicated for operative correction in Orientals, whereas it is seldom regarded as requiring treatment in other races. A prominent mandibular angle is often corrected by resecting the angle. However, subjects with a prominent mandibular angle often have a disproportional chin, and mandibular contouring surgery from the ramus to the symphysis is conducted effectively by resection of the angle and genioplasty. Advancement, recession, shortening, and/or elongation by horizontal or sagittal osteotomy of the chin were performed in our series of 16 Japanese patients. The resected width of the angle ranged from 10 to 15 mm, and the resected length ranged from 42 to 62 mm. Masseter muscle resection was combined with the treatment in 13 patients who requested it. In the concomitant genioplasty, advancement was performed in six, reduction in one, and simultaneous advancement and elongation in nine cases. Operative results were satisfactory, and the patients' facial contours were improved substantially by mandibular contouring from the ramus to the symphysis in all cases. The author concludes that the entire mandibular contour should be considered in mandibular angle plasty, and concomitant genioplasty based on racial anthropometric measurements is very effective.