Long Midface and Lower Face Long-Face, Long-Chin Surgery - Cases That Do Not Require Double-Jaw Surgery

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

Today, I’d like to talk about long-face and long-chin surgery, along with a case of a patient who underwent long-chin surgery because they wanted a shorter-looking face.

First, with long-face surgery, we need to accurately identify the “cause of the length” in the face.

In consultations, many people with long faces or long chins worry that double-jaw surgery is the only answer.

Long-face surgery is not always solved by double-jaw surgery alone; it depends on the condition of the patient’s facial bones.

The human face is broadly divided into three parts.

From the forehead to the eyebrows is called the “upper face,” from the eyebrows to the tip of the nose is the “midface,” and from the tip of the nose to the chin is the “lower face.”

When the face appears long, there are two cases: 1) a long midface and 2) a long lower face.

If the distance from the eyebrows to the tip of the nose is long when looking at the face, the maxilla, or upper jawbone, needs to be shortened.

Therefore, a long midface requires “double-jaw surgery.”

If the upper jaw shown in the illustration is long and too much of the teeth and gums show when smiling, you can get a big effect from double-jaw surgery, which cuts the middle of the upper jaw and moves it upward.

However, if the midface from the eyebrows to the tip of the nose is long overall, even if double-jaw surgery reduces the length of the maxilla, it cannot alter the firmly fixed position of the nose or the soft tissues.

The bone length will be reduced, but since the position of the nose does not change, there are limits to adjusting the visible length of the midface. You may ask whether the nose length could be shortened instead, but although the tip of the nose can be shortened surgically, it is impossible to shorten the entire nose.

If the lower face from the tip of the nose to the chin is long, even if the jawbone is very prominent, it can be addressed with a relatively simple contouring surgery.

For a long face with a developed lower face, the length of the lower jaw is reduced through long curve resection and chin surgery.

The length can be reduced with chin surgery alone, but if you want a greater effect, it is better to combine it with square jaw surgery.

I’ll explain this with an actual patient case.

Before surgery

If you look at the preoperative photo, you can see that the patient has a long lower face from the tip of the nose to the chin.

Because of the strongly developed lower jaw, this patient was considering even “double-jaw surgery” when they first visited the clinic.

Preoperative CT

On the actual CT, you can see that the chin is long and the lower jawbone is broadly developed.

Based on my diagnosis, I explained that the long-face correction plan would be to reduce the overall length of the lower jaw through long curve resection and inferior border reduction of the mandible (LBO).

Pre- and postoperative CT

In this patient, the square jawbone was removed with long curve resection. Rather than a standard procedure to soften the angle of the jaw near the ear, the bone was resected in a way that reduced the length, and the front chin bone was shortened by performing inferior border reduction of the mandible.

After square jaw surgery and chin surgery

This photo was taken 6 weeks after surgery.

If you look only at the lower jaw, you can see that the chin length has been reduced and the lower jaw has been balanced, greatly reducing the impression of a long face.

In fact, chin surgery alone can reduce length, but rather than simply reducing the absolute length, it is better to also consider facial balance and proportions and perform square jaw surgery together.

Square jaw surgery, masseter muscle reduction surgery, chin surgery

Pre- and postoperative CT

In all facial contouring surgeries, including long-face and long-chin surgery, the most important thing is proportion.

Because there is an ideal facial proportion, it is not always true that big eyes, a high nose, and a pointed chin are what make someone look beautiful.

Just as there are many actresses among celebrities who do not have double eyelids or who have low noses yet are still very beautiful, the face, like the body, is perceived as beautiful when the proportions are balanced and the features are harmonious.

In the past, it was said that an ideal ratio was 1:1:1 for the upper face, midface, and lower face.

However, these days, the trend is that the younger someone looks, the more beautiful they are considered.

As for aesthetics, opinions differ from person to person, but in general, the shorter the chin, the younger it looks.

Among young Korean women, many prefer a short, small chin.

People who come in for consultations for long-face and long-chin surgery also usually ask for proportions closer to 1:1:0.8 rather than 1:1:1.

Square jaw surgery, chin surgery

Pre- and postoperative CT

At this point, just because it is long-face or long-chin surgery, you should not shorten the length unconditionally or cut the jawbone the way you would in a typical square jaw surgery.

Among patients who visit for revision surgery, there are many who had long-face or long-chin surgery but come in because the altered appearance has become a problem.

A face can appear long or short depending on angles and proportions.

If surgery is performed without considering proportions, the absolute length of the face may become shorter, but the overall balance of the face will be disrupted and it will no longer look attractive.

If the surgery is performed like a standard square jaw procedure, it can create what people commonly call a “dog jaw” appearance.

And the biggest problem is that after long-face surgery, the face may actually look longer after surgery than before.

Square jaw surgery, chin surgery

Pre- and postoperative CT

This patient had surgery earlier this year, and when they came in for a follow-up check, I still remember that their expression was much brighter than before, even more than the change in the face after surgery. More than the face itself, I think this is when I feel the greatest reward as a doctor—when I see a patient whose expression has brightened like this.^^

For long-face and long-chin surgery, accurate diagnosis with CT imaging is the most important thing.

You should not undergo a large, inappropriate surgery because of a wrong diagnosis, or end up with an awkward face that is not attractive.

If you think your face looks long, I recommend visiting a clinic for an accurate diagnosis and, before deciding on surgery, making sure to visit several hospitals.

Thank you for reading this long post.