[Paper Review] About Facial Bone Contouring Surgery for Asians

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

Today, after a long time, I’d like to do a paper review.

This paper was written by Professor Jong Woo Choi at Asan Medical Center and published last year. It summarizes facial bone contouring surgery for Asians.

To summarize the paper, this surgery has a long history and has undergone many changes over time.

From here, let’s take a closer look at its development process, the latest trends, major surgical techniques, new technologies, and postoperative care.

Origins and Early Stages

Early facial contouring surgery focused on reducing the mandibular angle and cheekbones.

At the time, there was a strong tendency to pursue a Western facial shape, so reducing the cheekbones and mandibular angle to create a sharper face shape was an important goal.

It was especially popular among Asian women, and mandibular angle reduction and cheekbone reduction were the representative procedures.

Modern Trends

Modern Asian facial contouring emphasizes the concept of “Profiloplasty,” which aims to achieve three-dimensional facial balance.

This “Profiloplasty” refers to pursuing overall facial harmony while preserving the patient’s ethnic identity.

Rather than simply reducing specific areas, it is an approach that plans surgery while considering the three-dimensional contour of the entire face.

Figure 1: An illustration showing various aspects of three-dimensional facial contouring surgery

Rather than simply following Western aesthetic standards, the focus is on preserving each individual’s unique facial features and creating a balanced face, thereby expressing a more natural and harmonious contour.

Major Surgical Techniques

1. Mandibuloplasty

• Curved Ostectomy: A method that reduces the size of the mandibular angle and makes the jawline softer.

This reduces the angle of the jaw, making the overall facial line appear slimmer.

• Narrowing Genioplasty: A procedure that reduces the width of the chin to create a slimmer facial line.

It usually involves making an incision in the central portion to reduce width, and if necessary, the chin can be advanced to improve the side profile of the jawline.

• Long-curved Osteotomy: A method that osteotomizes the entire mandible along one curve to create a more natural facial contour.

This technique can provide more consistent results than making separate incisions in each area.

• Oblique Osteotomy: A method that creates a more precise contour by performing osteotomies at multiple angles.

It is especially effective in addressing asymmetry.

These are examples of patients who underwent square jaw surgery and T-osteotomy surgery.

This is a photo of a patient who underwent one-piece mandibuloplasty, also known as contour shaving.

2. Malarplasty

• L-shaped Osteotomy: A technique that reduces the cheekbone and arch at the same time.

This method is especially effective for reducing both the anterior projection and lateral projection of the cheekbones.

• Reduction and Setback Techniques: These reduce the cheekbones and move them backward to create a softer facial contour.

This is used especially when the cheekbones are prominent.

• Intraoral Infracture: A method of gently adjusting the cheekbones from inside the mouth, with the advantage that no postoperative scar remains.

This is a photo of a patient showing various surgical methods and the results of those procedures.

3. Genioplasty

• Horizontal Osteotomy: A method of horizontally osteotomizing the chin to reduce its width.

It is mainly used to improve a broad and flat chin.

• Inverted V-shaped Osteotomy: A technique that reduces the width of the chin and adjusts its vertical length, creating a more three-dimensional jawline. It is especially suitable for patients with a long chin.

The paper also discusses the various methods of T-osteotomy surgery, which I have mentioned in one of my columns.^^

New Technologies

1. Computer Simulation Technology

Computer simulation technology is very helpful for making accurate preoperative plans and predicting outcomes.

It allows patients to preview their postoperative appearance and gives them greater confidence during the planning process.

2. 3D Printing Guides

3D printing guides are useful for accurately following the osteotomy lines during the actual surgery.

In particular, when visibility is limited, using a 3D printing guide can shorten the surgery time and improve the accuracy of the results.

Postoperative Care

1. Use of a JP Drain

A JP drain is used after surgery to prevent hematoma.

It helps the recovery process by removing fluid that may accumulate at the surgical site.

2. Oral Antibiotics

Antibiotics are taken for a certain period after surgery to prevent infection.

This helps make recovery smoother and minimizes the risk of infection.

3. Wearing an Elastic Band

After surgery, an elastic band is worn to help the soft tissues adapt to the new skeletal structure.

This is effective in reducing postoperative swelling and speeding up recovery.

Asian facial contouring surgery has evolved from the early focus on reducing the mandibular angle and cheekbones to a direction that now aims not simply to reduce specific areas, but to achieve three-dimensional balance across the entire face.

Modern surgical techniques can provide more precise and refined results tailored to each individual’s needs and desired outcome, and thorough preoperative and postoperative planning and management, along with the introduction of new technologies, further enhance these results.

This paper seems to organize various surgical methods performed in Korea very well.

If you read this article as well, I think it will help you understand the surgical methods.

Thank you.