Which Surgery Do I Need: Contouring Surgery or Double-Jaw Surgery?

Hello, this is Dr. Jo Hyun-woo from 입체성형외과.

One of the questions patients ask during consultations is, “Doctor, do I need double-jaw surgery? Or do I need contouring surgery?”

I get this question a lot.

At 입체성형외과, we do not perform double-jaw surgery.

So for patients who need double-jaw surgery, I first tell them that double-jaw surgery is necessary.

Then let me explain which patients are better suited for double-jaw surgery.

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The first type of patient who needs double-jaw surgery is someone with a Class III malocclusion.

In the case of a Class III malocclusion, the lower molars are positioned in front of where they should be.

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Looking at the overall face, the lower jaw appears to protrude forward like this.

When it commonly looks like a protruding jaw and the bite does not align, double-jaw surgery is the most effective way to change the facial appearance.

Depending on how prominent the patient’s jaw is, the case may be treated with lower-jaw corrective surgery alone, or it may require surgery on both the upper and lower jaws.

I will explain the details in the double-jaw surgery section.

Among patients with a mild Class III malocclusion, some come after first correcting their teeth with orthodontic treatment to achieve a normal bite.

But in my view, since the lower jaw is already protruding forward, lower-jaw surgery alone will not produce a satisfying result, so I may recommend double-jaw surgery.

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If lower-jaw surgery is performed as shown in the figure above, this kind of result can be obtained.

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Next, patients for whom I recommend double-jaw surgery are those with severe facial asymmetry.

For people whose jaw is significantly crooked like this, it is actually difficult to achieve a dramatic result without double-jaw surgery.

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In patients with this degree of skeletal asymmetry, the right side of the upper jaw is longer, and the lower jaw is rotated significantly to the left.

There is also a big difference in the length of the part of the lower jawbone called the ramus.

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When double-jaw surgery is performed like this, you can see a dramatic correction of the facial asymmetry.

Of course, perfect bilateral symmetry cannot be achieved 100%, but nowadays 3D programs for diagnosing and planning double-jaw surgery have become very advanced, so good results can be obtained after surgery.

However, for people who feel that double-jaw surgery is too burdensome, a compensatory procedure can be performed by asymmetrically trimming the lower jaw to some extent.

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How does it look? The asymmetry has been corrected to some extent, but there are still some unsatisfactory points.

In cases of left-right asymmetry, it is often not only the bone but also the soft tissue that is more abundant on one side.

Therefore, if you are not averse to double-jaw surgery, you can obtain good results with it. But if you want only a certain degree of improvement, contouring surgery can also be an option.

Among the patients who visit me for consultations, the largest group is those who come to address a long face.

I have previously explained in a column how to correct a long face.

In fact, among people with a long face, many have a long midface.

For those with a long midface and a short lower jaw, I believe the only option available is double-jaw surgery.

Looking at this patient, the face is long overall, but the lower jaw is short.

In such cases, it can be shortened with upper-jaw corrective surgery.

In the before-and-after images, you can see that the length of the upper jaw has been shortened, making the facial bones appear slightly rounder.

You can think of it as cutting the upper jawbone and moving it upward as shown in the figure above.

In this case, you can feel that the face becomes dramatically shorter.

Even among celebrities who are considered beautiful, there are some with a long midface.

When you look at people like this, they have beautiful faces, but the midface is a little long.

I do not think that having a long midface automatically means someone is not beautiful or attractive.

Also, among the people who come for consultations, there are patients whose midface is long and whose lower face is also long.

For these patients, if double-jaw surgery feels too intimidating, lower-jaw surgery alone can still effectively make the face appear shorter.

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If surgery is performed to shorten the lower jaw, you can see that a long face is significantly improved.

I have written about this in detail in a column, so I hope you will take a look.

Today, I looked at the types of patients for whom double-jaw surgery may be more effective than contouring surgery.

If you choose surgery according to your own situation, I think you can obtain good results without too much difficulty.

I hope this was helpful.

Thank you.