Satoh Kaneshige, Mitsukawa Nobuyuki
From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Ann Plast Surg. 2014 May;72(5):498-502. doi: 10.1097/SAP.0b013e31826a18d3.
In aesthetic mandibular contouring surgery, which is often conducted in Asians, the operative procedure is thought to deliver a more aesthetic mandibular shape by means of contouring conducted as a whole from the ramus to the symphysis. The authors describe the refined concept and operative procedures of mandibular marginal contouring.
For the 7-year period from 2004 to 2011, mandibular marginal contouring has been used in 57 consecutive series of Japanese subjects. Patient ages ranged from 18 to 33 years, and the subjects included 15 men and 42 women. The surgery was carried out by cutting off the protruding deformed mandibular margin from the ramus to the symphysis. In 53 of 57 cases, the focus was on angle contouring. Concomitant genioplasty by horizontal osteotomy of the chin was conducted in 42 of 57 cases (recession, advancement, shortening, elongation, and correction of the shift variously). In 22 materials exhibiting bulk around the mandibular, the ramus to the body was excised sagittally and thinned. In all the patients, mandibular marginal contouring from the ramus to the symphysis was completed. Partial masseter muscle resection was conducted in 11 of 57 cases.
Mandibular contouring effectively achieved a highly satisfactory result in all cases. The upper portion of the peripheral branch of the trunk of the mental nerve was dissected by an electric scalpel in 1 case but sutured immediately using an 8-0 nylon stitch. Transient palsy of the mental nerve was noticed in a few cases but subsided in 1 to 2 months. No particular complications were encountered. No secondary revision was required in this series.
In mandibular angle plasty, mandibular marginal contouring from the ramus to the symphysis should be carried out by cutting off the angle keeping in mind the entire mandibular shape. This concept and the procedure can deliver greater patient satisfaction.
在常针对亚洲人开展的下颌轮廓美容手术中，人们认为手术操作通过从下颌升支至下颌联合进行整体塑形，可塑造出更美观的下颌形态。作者阐述了下颌边缘轮廓塑形的精细概念及手术操作方法。
在2004年至2011年的7年期间，连续57例日本患者接受了下颌边缘轮廓塑形手术。患者年龄在18至33岁之间，其中男性15例，女性42例。手术通过切除从下颌升支至下颌联合处突出变形的下颌边缘来实施。57例中有53例重点在于下颌角塑形。57例中有42例（分别进行了后缩、前突、缩短、延长及移位矫正等不同操作）同时通过颏部水平截骨术进行了颏成形术。在22例下颌周围有赘肉的病例中，从下颌升支至下颌体进行了矢状切除并变薄处理。所有患者均完成了从下颌升支至下颌联合的下颌边缘轮廓塑形。57例中有11例进行了部分咬肌切除术。
下颌轮廓塑形在所有病例中均有效取得了高度满意的效果。1例患者的颏神经主干外周支上部被电刀切开，但立即用8-0尼龙缝线进行了缝合。少数病例出现了颏神经短暂性麻痹，但在1至2个月内消退。未遇到特殊并发症。本系列病例无需二次翻修。
在下颌角整形术中，应通过切除下颌角来进行从下颌升支至下颌联合的下颌边缘轮廓塑形，同时要牢记整个下颌形态。这一概念及操作方法能让患者获得更高的满意度。
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