[Chin Surgery] Learning About Contouring Shave and T-Osteotomy with Real Patient Cases (2)

Hello. I am Dr. Jo Hyun-woo of iBitu Plastic Surgery.

Recently, there have been many chin surgery methods such as contouring shave, T-osteotomy, S-osteotomy, and W-osteotomy.

Some say T-osteotomy is better, while others say contouring shave is better, so I imagine patients may feel confused.

Today, as a board-certified plastic surgeon with 16 years of experience, I would like to provide accurate information about chin surgery.

There are many chin surgery methods available, but what many people are probably most curious about is the difference between T-osteotomy and contouring shave.

I will briefly show the surgical methods first and then explain them.

Chin Surgery, T-Osteotomy

First, T-osteotomy is a surgery that cuts the front chin in a T shape and removes the middle bone segment to reduce the width of the chin into a V-line.

The procedure begins by making a T-shaped osteotomy in the front chin area while avoiding the nerve line, then removing the middle bone segment, and bringing the cut ends of both sides of the chin together.

After bringing the bones together and fixing them with fixation pins, the remaining portions of the bones on both sides are osteotomized. T-osteotomy is performed through the process above.

Next, contouring shave is a surgery that, as shown in the diagram, removes a long segment in one continuous line from the square jaw to the chin.

In fact, I do not know where the term contouring shave started, but it is not a medical term.

The exact term is "Lower Border Ostectomy."

Which is better, T-osteotomy or contouring shave?

To give the conclusion first, if neither contouring shave nor T-osteotomy involves moving the chin forward or backward, there is "no difference in the result."

Even in papers, there are no differences in the outcomes between contouring shave, Lower Border Ostectomy, and T-osteotomy.

These two surgeries ultimately create the same V-line, and as mentioned earlier, they do not show any special difference in appearance.

I will show you CT images as well.

Chin Surgery, Before/After Contouring Shave

What you are looking at now is the before-and-after CT images of a contouring shave patient.

Chin Surgery, Before/After T-Osteotomy

And next are the before-and-after CT images of a T-osteotomy patient.

If you compare the jawlines, you can see that both the contouring shave patient and the T-osteotomy patient achieved a smooth V-line, meaning there is no difference in the surgical result.

Neither method is better than the other; the appropriate surgery should be selected according to the patient.

Then which chin surgery method is right for me?

Cases that require chin surgery include when the chin is wide and bulky, when the jawline is angular, when the front chin protrudes due to an underbite, or conversely, when chin development is insufficient, resulting in a receding chin. If the chin is not only wide and angular but also has an underbite or receding chin issue, then the chin must be moved backward or brought forward.

In such cases, only T-osteotomy can both advance and set back the chin at the same time, so contouring shave should not be performed and T-osteotomy is necessary.

Even just from the diagram of the surgical methods above, you can see that contouring shave does not allow forward or backward movement.

However, if the problem is simply a wide and angular chin without the need to move it forward or backward, then there is no need to cut the bone and fix it with pins as in T-osteotomy.

To summarize, if the problem is a wide and angular chin, both T-osteotomy and contouring shave ultimately produce the same V-line.

But if an underbite or receding chin is also an issue, the chin needs to be advanced or set back, so T-osteotomy is the more appropriate surgery.

In terms of surgical technique, contouring shave is somewhat more difficult.

However, an experienced specialist should be able to perform both surgeries safely.

T-Osteotomy Chin Surgery Real Case

iBitu Plastic Surgery

I will show you photos of an actual patient.

The photo you see is of a patient who underwent chin surgery with T-osteotomy this year. Compared with the square jaw, the chin is wide and blunt.

From the side, you can see that the chin is set back, so there is also a receding chin issue.

In this case, the surgery is performed by reducing the width of the front chin with T-osteotomy while also advancing and fixing the chin bone forward.

Next is a photo taken three months after T-osteotomy chin surgery. From the front, the width of the front chin has been reduced and it has become a refined V-line.

From the side, the recessed chin has been advanced forward, improving the receding chin issue as well.

As such, T-osteotomy is suitable in chin surgery when not only the width of the chin but also advancement or setback of the chin is needed.

Contouring Shave Chin Surgery Real Case

iBitu Plastic Surgery

Next is a patient who underwent chin surgery with the contouring shave method. Looking at the preoperative photo, the front chin has a large volume and the left and right sides are asymmetrical.

However, from the side, it does not seem necessary to advance or set back the chin.

In this case, both T-osteotomy and contouring shave are suitable.

This is a photo taken six months after contouring shave chin surgery. If you look at the jawline, the chin has been refined and brought together, and the asymmetry has also improved significantly.

Isn’t T-Osteotomy a more advanced chin surgery method?

One of the common misconceptions patients have is thinking that T-osteotomy or S-osteotomy is a more advanced surgery.

That is a mistaken idea. I think this may be because hospitals productize one surgical method and strongly advertise it in one direction.

Patients also ask whether S-osteotomy is a newer method than T-osteotomy, but T-osteotomy and S-osteotomy are the same surgical method with only different names.

When you look at this, it seems that it is really difficult for patients to distinguish accurate information.

As explained above, the surgical results of T-osteotomy and contouring shave are the same. If there is no need to move the chin forward or backward, there is no reason to insist on T-osteotomy.

Therefore, a specialist should be skilled at both T-osteotomy and contouring shave and should choose the appropriate method correctly according to the patient’s situation.

Another thing often asked during facial contouring consultations is the recovery period.

I have written a separate article about facial contouring recovery time with actual patient photos, so if needed, I recommend reading it.

So far, we have looked at chin surgery through a comparison of T-osteotomy and contouring shave.

Before surgery, please make sure to visit at least two or three hospitals and make the right choice. Thank you.