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Posts Tagged ‘jawline reshaping’

Case Study – Asian V Line Surgery

Monday, November 23rd, 2015

 

Background: Reshaping of the entire jawline to a more slim or narrowed shape has become known as V line surgery. It is most commonly done in Asians to change a wide and more square jaw to a more narrow and triangular one. It is a bony reshaping surgery which focuses on the chin anteriorly and the jaw angles posteriorly

The cornerstone of V line surgery is what happens in the anterior chin area. As the most projecting point of the lower jaw it must become less wide and often times vertically shorter or longer depending on the patient’s natural chin shape. This is usually done by various of osseous genioplasty concept where the chin bone is downfractured, a midline resection done and then put back together. A horizontal wedge reduction can be done to shorten it if the chin is initially vertically long or the reassembled chin can be put back together and brought forward for a horizontally deficient chin.

The secondary part of V line surgery is a change in the width of the jaw angle. In the past the jaw angle was merely amputated or cut off. While very effective this wipes out any jaw angle shape and can be prone to create soft tissue sag due to loss of ligamentous and muscular attachments. Today it is recogized that preserving the jaw angle shape is important and angle reductions can be done by either a burring reduction or an outer corticotomy.

Case Study: This 22 year Asian female was undergoing a variety of facial reshaping procedures including V line jawline reshaping surgery. She had a naturally short flatter chin and needed more horizontal projection as well as narrowing

Asian Female Jawline Narrowing result Dr Barry Eppley IndianapolisUnder general anesthesia, she had an intraoral horizontal chin osteotomy done with a midline wedge resection. The bones were put back together with 1.5mm plate and screw fixation and advanced 5mm. The bony stepoffs at the inferior border were trimmed behind the back edge of the osteotomy line.  Through different intraoral vestibular incisions the jaw angles were reduced by rotary burring, reducing the outer cortex almost to the marrow space.

Asian Chin Reshaping result side view Dr Barry Eppley IndianapolisAsian Female Jawline Reshaping result oblique view Dr Barry Eppley IndianapolisAt six months after surgery she had a much improved jawline shape. Due to the desire to have further horizontal chin projection, a secondary procedure was done to add a small curvilinear central chin implant of 5mms to create the final jawline shape now seen.

V line jaw reshaping surgery is technically challenging and requires expertise in chin osteotomies as well as mandibular ramus surgery. Secondary revisions are not rare and may need to be done to correct any residual bony asymmetries or projecion deficiencies.

Highlights:

  1. V line or jawline narrowing surgery is often a combination of chin and jaw angle bony changes.
  2. The most important element of v line surgery is the anterior chin which must be narrowed and often lengthened to create most of the effect
  3. Jaw angle width narrowing may also be necessary but it is important to avoid obliterating the shape of the jaw angle in doing so.

Dr. Barry Eppley

Indianapolis, Indiana

Surgical Techniques – Submental Jawline Shave for Inferior Border Irregularities after Chin Reduction

Monday, February 9th, 2015

 

Shaping of the jawline is done for many different reasons. The most common reason worldwide is tapering a wide jawline through a combination of a chin reduction osteotomies and jaw angle shaves or ostectomies. In other patients with just a large or long chin, a chin reduction osteotomy is used.

chin reduction osteotomy x-ray with shave line dr barry eppley indianapolisWhen the chin is vertically reduced the osteotomy line usually extends to the inferior border of the jawline below the mental foramen or even more posterior.  Depending on the amount of vertical chin bone reduction and the angle of the bone cut, the line of the jawline from the jaw angle (back) to the chin.(front) can become non-linear. A bump along the lower edge of the jawline behind the chin can occur because of the location of the vertical reduction. (anterior) This makes the chin vertically shorter in the front but boxy in shape and a fullness (bump) behind the chin on the jawline.

Jawline Shave Technique Dr Barry Eppley IndianapolisJawline Shave Reciprocating Saw Dr Barry Eppley IndianapolisReduction of this bump or hump on the jawline is best done through a submental approach. This provides the most direct access which is important is re-establishing a straight line along he lower edge of the jawline. This also places the bone work sufficiently below the mental nerve foramen to avoid injury to it. Removing the irregular jawline section is best done with a reciprocating saw to provide a smooth cut.

The submental approach to straightening a ‘crooked’ jawline by an inferior border irregularity or reducing its vertical length is the one most effective approach. Its limitations is that it can not reach all the way back to the ramus or jaw angle area.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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