Good for the Front View Effect in Square Jaw Surgery

Hello, I’m Director Jo Hyun-woo of Ipcheok Plastic Surgery.

Many people come in for consultations about square jaw surgery and say they want a small, slender jawline.

However, there is a common misunderstanding: having square jaw surgery does not automatically create a V-line.

First, square jaw surgery is an operation that trims the jawline into a slimmer shape by making a long curved osteotomy from the area below the ear to just before the chin bone.

Of course, reducing the prominent angle below the ear can make the face look smaller from the side, but what matters most is the front-view effect.

Thinking that square jaw surgery alone will improve the front view is truly a big misconception.

Let me show you the following example.

This is the patient’s preoperative CT scan. This patient came to our hospital hoping to look slimmer from the front.

On CT, you may wonder whether the square jaw bone is actually square.

On the other hand, if you look at the CT image from the side,

It looks like this. The jaw angle below the ear is lowered and appears to be almost 90 degrees.

The ideal angle is considered to be around 120 to 130 degrees.

Based on that, if we simulate it,

It looks like this. The line is clearly slimmer and falls more smoothly.

But did this patient’s square jaw also improve from the front?

If you look at the front view of the simulation image,

You might wonder whether this is the same as the preoperative photo shown earlier. No, it is not.

This is after the square jaw bone has been cut, yet it really looks very similar to the preoperative photo.

This is why square jaw surgery does not necessarily create a V-line from the front.

The square jaw bone, like the patient I just showed you, can either be curled inward in the jaw-angle area or spread outward.

If the bone is curled inward, like in the example patient, then no matter how much of the square jaw bone is removed, the front-view effect will be the same.

So you must change the idea that removing more automatically creates a V-line.

Now let me show you an example where the front-view effect is good for a square jaw bone that spreads outward.

These are preoperative photos. Let’s do a simulation.

As with the photos above, the angle has been nicely reduced from the side.

Then let’s look at the front view.

Unlike the first patient, you can see that it has also been reduced from the front.

Therefore, when performing square jaw surgery, it is very important to understand what shape your own bone has and proceed accordingly.

Then, does that mean that if the square jaw bone is curled inward, you cannot get a front-view effect?"

Absolutely not. The surgery that must be done for the front-view effect is called cortical osteotomy.

Here, I will explain what cortical osteotomy is and what effect it brings.

Cortical osteotomy reduces the volume of the side of the jaw. By removing only the outer layer of the three-layer bone structure, it can improve not only the side view but also the front-view effect. When the square jaw bone is cut, the outer cortex and inner cortex become exposed.

I will explain with photos.

You can see two layers of bone, right? The outer part of the square jaw bone is the outer cortex.

It varies by patient, but it usually has a thickness of 3 to 5 mm or more.

A total of nearly 1 cm on both sides is by no means a small amount in facial proportions.

Cutting and removing this part is called lateral cortical osteotomy, and shaving it without cutting is called lateral cortical shaving.

In fact, the effect of this surgery is so great that when square jaw surgery is performed on people whose bone curls inward or whose jaw angle below the ear is not very large, the angle is often not reduced very much and the surgery is mainly focused on cortical osteotomy.

That is why I think of this cortical osteotomy as the highlight of square jaw surgery, but many people overlook it.

Lateral cortical osteotomy is a very important part of square jaw surgery, and it is what makes a V-line possible from the front.

If you look at the square jaw bones of patients who actually had contouring surgery, can you see that they look V-shaped?

Of course, some people had a reduced angle below the ear, but it is because the protruding outer cortex has been reduced and they appear to have a V-line.

That is how important lateral cortical osteotomy is.

If you are curious here, you may be wondering about the difference between lateral cortical osteotomy and lateral cortical shaving.

Please refer to the column below.

In conclusion, when surgery is performed safely, lateral cortical shaving alone can still produce highly satisfying results.

Because the thickness of the cortex differs from person to person, the amount of cortex that needs to be removed also varies individually.

Excessive cortical osteotomy can cause nerve damage as a complication of square jaw surgery, so it is better to have the surgery performed by an experienced specialist.

Today, I explained that square jaw surgery does not always create a V-line, and how important lateral cortical osteotomy is in square jaw surgery. It is best to analyze your own CT scan and choose the right surgery for yourself in order to achieve good results.

Thank you.