Which Areas Can Be Shaved, and How Effective Is It?

Hello. I’m Dr. Jo Hyun-woo of Lip Plastic Surgery.

Today, I’ll talk about “shaving,” one of the methods used in contouring surgery.

There are osteotomy procedures that cut bone, but bone can also be shaved down without cutting it by using a method called shaving.

Rasp

Burr

As shown in the photos, bone can be shaved using an instrument called a rasp.

When the amount of bone to be shaved is small, a burr can also be used.

So, in which surgeries can this kind of shaving be done?

Looking at the history of cheekbone surgery,

Since 1983, people began reducing cheekbone volume by shaving the bone. It is a surgery with a long history.

However, because the instruments at the time were not very effective, it took too long to reduce bone by shaving, and this method gradually disappeared.

As time passed, from the late 2010s, surgeons began performing cheekbone reduction by shaving bone again,

and with improved instrument performance, it became possible to shave a very large amount much more quickly.

However, to shave down the entire cheekbone, a lot of dissection is needed, and apart from the 45-degree cheekbone area, the bone in other areas is less than 5 mm thick.

Sometimes when I see patients who have had shaving in that area, the bone has become as thin as a sheet of paper.

If you look at the CT above, this patient visited after having shaving performed at another hospital 10 years ago, and the cheekbone arch had become too thin.

It was at the point where it could break if pressed by hand, so you should be very careful in such cases.

In my case, I only shave the 45-degree area of the cheekbone.

That is because the 45-degree cheekbone is thick, so it is difficult for shaving to make the bone so thin that it becomes dangerous.

This is a cross-section of the 45-degree area of the cheekbone after being cut. As you can see, the outer cortex is about 3 mm thick.

Of course, that does not mean it is impossible to shave beyond the cortex, but since the inner cancellous bone is an area where there is a lot of bleeding,

it may also help recovery after surgery to shave carefully there as well.

Another area where shaving is done in contouring surgery is cortical shaving, which is performed together with square jaw surgery.

Square jaw surgery, cortical shaving, chin surgery

Cortical shaving

When there is a need to be careful about the nerves in the cortical area, or when the cortex is not very large, shaving alone can still produce a significant effect.

I also solve it with shaving when cortical osteotomy is not necessary.

Front chin shaving

Lastly, when shaving is performed in chin surgery, it is used to trim areas where the chin appears unevenly enlarged to one side or where there is a protruding portion.

45-degree cheekbone shaving

One of the questions many people ask about shaving is whether the shaved bone grows back.

Of course, after shaving, the outer surface will be lightly covered again with bone. However, it does not grow back by the same amount as the 3–4 mm that was shaved off, so there is no need to worry too much.

In conclusion, shaving is a surgical method that can produce good results as an alternative to osteotomy when used properly.

However, if thin bone is shaved or if excessive shaving is performed, the bone may become unstable and there may be a lot of bleeding, leading to other side effects.

Therefore, shaving only the necessary amount in the necessary areas will allow for safer and more satisfying results.

Thank you.