[Long Chin/Protruding Chin Correction] Why Do Side Effects from Shaving and Chin T-Osteotomy Occur?

Hello. I’m Dr. Jo Hyun-woo from 3D Plastic Surgery.

In the previous column, we looked at correction for a short chin and a weak chin.

Today, let’s talk about surgical methods for correcting a long chin and a protruding chin.

When consulting with patients, many people who have a long chin that gives a protruding-chin impression worry that double-jaw surgery is the only answer.

Double-jaw surgery is not always the only solution; it depends on the condition of the patient’s facial bones.

At this time, if the lower face from the tip of the nose to the chin is long, the length can sometimes be reduced with chin surgery alone.

In such cases, chin surgery can broadly be divided into 'shaving' and 'T-osteotomy.'

First, let’s look at 'shaving.'

Inferior border reduction of the chin

Shaving (inferior border reduction of the chin) is a surgery that cuts a long line from the square jaw to the chin in one continuous sweep.

Even from the surgical diagram above, shaving cannot advance or set back the chin, so if chin advancement or setback is not needed and the issue is a broad, long chin, shaving is recommended.

(Left) Before surgery (Right) After surgery

The patient above underwent chin reduction using the 'shaving' method. Looking at the preoperative photo, the chin appears bulky, and the left and right sides are asymmetrical.

However, from the side view, it does not seem necessary to move the chin forward or backward.

In this case, both T-osteotomy and shaving are appropriate.

Next, let’s look at 'T-osteotomy.'

If the chin is not only wide and angular, but also accompanied by a protruding chin or a weak chin, then the chin needs to be moved backward or advanced.

Because only T-osteotomy can both advance and set back the chin, shaving should not be performed in such cases, and T-osteotomy is needed.

T-osteotomy is a procedure in which the front chin is cut in a T shape and the central bone segment is removed to narrow the width of the chin into a V-line.

In this type of osteotomy that removes a bone segment, once the chin segments are brought together, a secondary angle (step deformity) inevitably occurs, as shown in the figure above.

To eliminate the secondary angle, additional bone trimming is performed, or if a greater effect is desired, it is advisable to combine the procedure with square jaw surgery.

(Left) Before surgery (Right) After surgery

Next is a patient who underwent chin setback surgery using 'T-osteotomy.' From the side view, the chin projects forward and also has a protruding-chin problem.

In this case, the surgery is performed by reducing the width of the front chin with T-osteotomy while simultaneously moving the chin bone backward and fixing it in place.

Especially when discussing the side effects of T-osteotomy, the term secondary angle is often explained.

In fact, this should be understood not so much as a side effect, but more as a level of incomplete finishing after surgery.

This area can be felt through the skin, and in severe cases, it can even be visible from the outside of the skin.

Therefore, surgery to smooth the entire jawline is absolutely necessary.

(Left) Before surgery (Right) After surgery

If you compare the jawline, you can see that both the shaving patient and the T-osteotomy patient achieved similar surgical results with a smooth V-line.

Neither surgical method is better than the other; in the end, the appropriate procedure must be chosen according to the patient.

Through a careful consultation with the surgeon, it is best to undergo the surgery that is most suitable for you.

Thank you.