Square Jaw Reduction Surgery

 

677. <Square Jaw Reduction Surgery>
Square jaw surgery reduces the width of the lower jaw (mandibular body) to create a slimmer, more defined jawline. There are two main approaches:
1️⃣ External incision behind the ear to remove the jaw angle (preauricular square jaw surgery)
2️⃣ Intraoral incision inside the mouth to shave down part of the mandibular body (oral square jaw surgery)

The external method avoids an incision inside the mouth, but it mainly targets the jaw angle, offering side-view improvement only. It often fails to reduce the front view width because the mandibular body isn’t properly addressed. Also, if the patient has a receding chin along with a square jaw, a chin procedure (which requires an intraoral incision anyway) becomes necessary — negating the original advantage.

More importantly, external incisions risk damaging facial nerves located near the ear. If injured, permanent facial paralysis could result. So, in trying to avoid intraoral incisions for a quicker recovery or lower cost, one might risk severe complications.

In contrast, oral square jaw surgery safely exposes the bone through a cut inside the mouth. We then perform a lateral cortectomy, removing the outer bone layer. CT scans help map the inferior alveolar nerve, and if the nerve runs close to the bone surface, we use an ultrasonic saw, which cuts bone but not soft tissue — minimizing nerve injury risk.

Because bone cutting can cause bleeding, we use hypotensive anesthesia to lower blood pressure and reduce bleeding during surgery.

If chin surgery is also needed, the intraoral approach allows full access to the jawbone. This makes it easier to correct asymmetry, advance the chin, or reshape it with precision — unlike the limited visibility in external methods.

In short, square jaw surgery is safest and most effective when done through the mouth using ultrasonic tools and hypotensive anesthesia. This approach allows both functional safety and faster recovery.

Square jaw reduction sculpts the overgrown lower jaw to enhance balance and aesthetics.

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