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Mandible Angle Resection Mandible Plasty

Homepage Star of July 2015
[ Author:Fushun Ma | Time:2016-02-01 22:05:24 |  Font Size: [Large Medium Small]
Tags: mandible angle, mandible resduction, square face, face reduction

Some of the square face is mainly due to the overgrowth of the mandible angle, while the masseter muscle is not remarkably oversize. In this sense the mandible angle should be bulkily chop off in order to get rid of the square shape of the lower face. When we cut one corner off from a square we get a pentagon. Similarly if we cut the angle of the mandible  off straightly we get two angles. To avoid the formation of double mandible angles the mandible body and mandible edge should also be trimmed accordingly ensuring the smooth transition from the reshaped mandible angle to the body. Those who have big mandible angles usually have hypertrophic masseter muscle thought the muscle may not bulge out. Once the muscle attachment at the mandible angle is released the muscle mass will show off. So the author routinely do partial muscle resectomy with the angle reduction.

The young man in this page had a typical square face. Though the size of his face was not big his facial organs were crowdly located in the middle of his face. So there was  indication for him to do a mandible reduction surgery to make his facial outline smaller. The diagnosis of benign mandibular hypertrophy can be made based on physical examination. However CT scanning of the facial bone is recommended before surgery to rule out disease or conditions that could cause localized mandible angle enlargement such as Fibrous Dysplasia and Bone Cyst.

Mandible Angle Resection Mandible Plasty
In this case the mandible reduction was mainly concentrated on the mandible angle, after surgery the facial contour improved remarkably.

mandible angle reduction
Chin up position the mandible angle is much smaller in the after surgery photo and they are also more symmetric.

mandible reducction mainly concentrated on the mandible angle
Mandible angle reduction doesn't mean cut the mandible angle completely but reserve it and let the reduced angle match the rest of the mandible bone.

angle reduction for mandible bone
Before surgery the mandible bone seems too big for his face. After surgery its size match the face better.

The surgery this young man underwent was mandible bone reduction (angle reduction dominated) plus masseter muscle partial resectomy. Because the angles of his mandible were not eversion, instead they protruded posterior inferiorly, lateral mandible cortex or mandible lower edge reduction alone could not effectively trim down the size of the mandible bone and could not improve the facial figure of this young man. What he needed was a mandible angle reduction with a supplemental mandible body reduction. He eventually did angle dominated mandible reduction. Upon 6 years post surgery follow-up he was satisfied with his post surgery result.

As the post surgery photos were taken 6 year after surgery all swelling and internal scar had been subsided completely at this time, the after surgery photos at this page presents a stabilized post surgery result. A remarkable change can be noticed if comparing the before and after surgery photos. However there is no traces of localized indentation or "horse face" deformity caused by overdone straight line osteotomy mandible angle reduction. This is a male patient with thin subcutaneous tissue and also 6 years had been passed since his surgery, there was enough time for any kinds of swelling to be absorbed, so any defect on the mandible bone will show off. Since not signs of deformity on the lower face it is safe to say the shape of his mandible bone normal.

In the frontal view photos the mandible angles area changed in a great deal, as a result the size of the lower face reduces largely and his facial organs are no more crowded but fairly spread out on the parameter of the face.  In other angle of view, the mandible angles are much smaller in the after surgery photos. However the mandible angle still be noticeable as an anatomical landmark on the face. The size of the mandible bone is also smaller and fit to the size of the whole face well.

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