[Chin Surgery] Learning About Contouring Shaving and T-Osteotomy with Real Patient Cases (3)

Hello, this is Injeok Plastic Surgery.

Recently, there have been many chin surgery methods available, such as contouring shaving, T-osteotomy, ㅅ-osteotomy, and W-osteotomy.

In some places, people say T-osteotomy is better, while in others they say contouring shaving is better, so I think it may be confusing for patients.

Today, we would like to provide the correct information about chin surgery.

Although there are many chin surgery methods, what many people are probably most curious about is the difference between T-osteotomy and contouring shaving.

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

Chin surgery

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

The procedure is performed by making a T-shaped osteotomy of the front chin while avoiding the nerve line, removing the central bone fragment, and then bringing the cut ends of the chin together.

After the two bones are brought together and fixed with pins, the secondary angles of both jawbones are trimmed.

T-osteotomy is performed through the process described above.

Next, contouring shaving is a surgery in which bone is shaved continuously from the square jaw to the chin, as shown in the illustration.

In fact, I am not sure where the term contouring shaving came from, but it is not a medical term.

The accurate term is Lower Border Ostectomy.

Which surgery is better, T-osteotomy or contouring shaving?

To get straight to the point, if the chin is not being moved forward or set back, there is no difference in the results between contouring shaving and T-osteotomy.

Even in studies, it is stated that there is no difference in outcomes between contouring shaving, Lower Border Ostectomy, and T-osteotomy.

The two surgeries ultimately create the same V-line, and as mentioned earlier, there is no special difference in appearance.

I will show CT images as well.

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

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

If you compare the jaw lines, you can see that both the contouring shaving patient and the T-osteotomy patient achieved a smooth V-line, and there is no difference in the surgical results.

Neither method is superior to the other; the appropriate surgery must be selected depending on the patient.

Then what kind of chin surgery is right for me?

Cases that require chin surgery include a chin that is wide and bulky, a jaw line that is angular, a protruding chin due to underbite, or, conversely, a weakly developed chin causing a receding chin.

If the chin is wide and angular, and there is also an underbite or receding chin issue, then the chin needs to be moved backward or advanced forward.

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

Just by looking at the illustration of the above surgeries, you can see that contouring shaving cannot move the chin forward or backward.

However, if there is no need to advance or set back the chin and the only issue is a wide, angular chin, 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 shaving ultimately produce the same V-line.

However, if an underbite or receding chin is also an issue, the chin must be advanced or set back, so T-osteotomy is the appropriate procedure.

Real T-osteotomy case

The photo you see shows a patient who underwent chin surgery with T-osteotomy. Compared with the square jaw, the chin looks blunt.

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

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

Next is a photo taken 6 months after T-osteotomy chin surgery.

From the front, the width of the chin has been reduced and it has become a slimmer V-line.

From the side, the receding chin has been improved by advancing the previously set-back chin forward.

As such, T-osteotomy is suitable when chin surgery requires not only reducing the width of the front chin but also advancing or setting back the chin.

Real contouring shaving case

Next is a patient who underwent chin surgery using the contouring shaving method.

Looking at the preoperative photo, the front chin has a large volume, and the left and right sides are asymmetric.

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

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

This photo was taken 6 weeks after contouring shaving chin surgery.

If you look at the jaw line, the chin has become slimmer, and the asymmetry has also improved significantly.

Isn’t T-osteotomy the more advanced procedure?

One of the common misconceptions patients have is that T-osteotomy and ㅅ-osteotomy are more advanced surgeries.

That is incorrect. It seems this may be because hospitals brand a single surgical method and strongly advertise one side.

Patients also ask whether ㅅ-osteotomy is a newer surgical method than T-osteotomy, but T-osteotomy and ㅅ-osteotomy are the same surgical method; only the name is different.

Seeing this, I think it must be really difficult for patients to distinguish correct information.

As explained above, the surgical results of T-osteotomy and contouring shaving are the same.

If advancement or setback of the chin is not needed, there is no reason to insist on T-osteotomy.

Therefore, a specialist should be skilled in both T-osteotomy and contouring shaving and should choose the right method appropriately according to the patient’s situation.

One of the questions most often asked during facial contouring consultations is the recovery period.

I have written a separate column about the recovery period after facial contouring surgery with real patient photos, so if you need it, I recommend reading it.

Today, we learned about chin surgery by comparing T-osteotomy and contouring shaving.

Before surgery, please make sure to visit at least 2 to 3 hospitals and make the right choice.

Thank you.