Mandibular Surgery

 

687. Mandibular Surgery

Mandibular surgery reshapes the lower jaw to improve facial harmony, occlusion, and function. It starts by evaluating the chin’s position. In cases of a recessed chin, genioplasty (chin advancement) is performed through horizontal osteotomy. If the chin is blunt or wide, a T-shaped osteotomy can advance and refine it. For severe retrusion affecting breathing (like sleep apnea), genioglossus advancement surgery may be added for functional improvement.

Asymmetric chins are corrected with wedge osteotomy, followed by long curved mandibular angle contouring and cortical shaving to create a slimmer “V-line.” In cases where a T-osteotomy is not suitable due to a wide midline, surgery is done in two stages—initial contouring followed by chin advancement after 6 months.

For patients with protruding “witch chin,” chin reduction is combined with V-line contouring to soften the look. When the entire lower jaw is overly forward and misaligned, sagittal split ramus osteotomy (SSRO) moves the jaw backward using a wafer to properly align the bite. In cases of severe asymmetry, vertical ramus osteotomy is preferred for better nerve protection and jaw correction.

Advanced techniques now allow 3D simulation and custom surgical guides to minimize errors and match surgical results with pre-op plans. Endoscopic-assisted surgery reduces swelling, and navigation systems help confirm accurate jaw positioning during surgery.

In older patients, jaw contouring may lead to loose skin. A facelift can be done simultaneously to lift and tighten the jawline, ensuring youthful results.

Post-op, jaw joint (TMJ) rehabilitation is critical. Without proper exercises, the joint can stiffen, so guided movement and recovery protocols are essential to prevent long-term dysfunction.

Mandibular surgery is a key part of facial contouring and orthognathic surgery, shaping the foundation of the lower face.

[Mandibular surgery is the foundation of lower facial sculpting.]
– 687mm Growing Pine Tree –