Intraoral Curved Ostectomy for Prominent Mandibular Angle by Grinding, Contiguous Drilling, and Chiseling

There are several surgical techniques for mandibuloplasty, for example, ostectomy of the lateral cortex around the mandibular angle, angle-splitting ostectomy, sagittal split ramus ostectomy, multistage osteotomy of the mandibular angle. These techniques all have achieved excellent aesthetic results, but they require a high level of skill and are time consuming. From July 1995 to June 2010, a total of 1006 patients underwent intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling in our department. A round bur was used to reduce the outer cortex thickness of the mandible body. The ostectomy line on the mandibular angle was penetrated contiguously using a long-shaft bur drill. A curved-headed chisel approximately 10 mm in width was hammered to separate the redundant mandibular angle. Concurrent procedures such as reduction malarplasty and genioplasty were performed in patients with protrusion of the malar bone and microgenia. A total of 992 patients were satisfied with the final facial contour. The square-shaped appearance was converted to an ovoid, slender, and feminine facial contour from the frontal view. Ninety-three patients underwent postoperative complications. Among the 93 cases, there were 14 patients who were unsatisfied with the final results. The average operative time was 42 minutes for ostectomy of prominent mandibular angle. Intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling is an appropriate technique for correcting lower facial contour. The surgical technique is not complex, and the ostectomy is easy to manipulate. The operation consumes less time. Complications of various degrees are relatively lower, and most of them can be treated effectively. Both surgeons and most of the patients are satisfied with the results.