Lee Tae Sung, Park Sanghoon
Center for Maxillofacial Surgery, ID Hospital, Seoul, Korea.
Facial Plast Surg. 2020 Oct;36(5):602-612. doi: 10.1055/s-0040-1717080. Epub 2020 Dec 24.
A prominent mandible that gives a squared face in Asians is considered unattractive as it imparts a coarse and masculine image. Mandibular contouring surgery allows slender oval faces. The purpose of conventional mandible reduction is to make the lower face appear slim in frontal view and to have a smooth contour in lateral view. As shaping the lateral contour of the mandible alone may result in minimal improvement in the frontal view, surgical techniques to reduce the width of the lower face through narrowing genioplasty (i.e., the "V-line" surgery) and sagittal resection of the lateral cortex should be combined. Examination of the shape and symmetry, the relationship between the maxilla and the mandible, understanding overlying soft tissue contribution, and understanding the overall balance of the face are mandatory. An important factor influencing ideal facial shape is patient's personal preference, which is often influenced by his/her ethnic and cultural background. Especially when consulting patients of different nationalities or ethnic backgrounds, careful attention should be paid to the patient's aesthetic sensibility regarding the ideal or desirable facial shape. Narrowing the chin and modification of chin shape can be accomplished by narrowing genioplasty with central strip resection. This midsymphyseal sectioning procedure yields safe and very satisfactory results. This procedure not only augments the narrowing effect by leaving soft tissues attached to the bone but also enables modification of chin shape by altering the shape of resection. The surgeon should customize the surgery based on a comprehensive assessment of the patient's preoperative chin and mandible morphology complemented by an assessment of their aesthetic goals.
在亚洲人当中，突出的下颌骨会使脸部呈方形，被认为缺乏吸引力，因为它会给人一种粗犷和男性化的形象。下颌轮廓整形手术能打造出细长的椭圆形脸。传统下颌骨缩小术的目的是使正面观的下脸部显得苗条，侧面观轮廓平滑。由于仅塑造下颌骨的侧面轮廓在正面观中改善可能极小，所以应结合通过缩窄颏成形术（即“V 线”手术）和外侧皮质矢状切除术来减小下脸部宽度的手术技术。检查形状和对称性、上颌骨与下颌骨之间的关系、了解覆盖软组织的作用以及理解面部的整体平衡是必不可少的。影响理想面部形状的一个重要因素是患者的个人偏好，这通常受其种族和文化背景影响。尤其是在咨询不同国籍或种族背景的患者时，应仔细关注患者对于理想或期望面部形状的审美感受。通过带中央条带切除术的缩窄颏成形术可以实现缩小下巴和改变下巴形状。这种正中联合部切开手术能产生安全且非常令人满意的效果。该手术不仅通过保留附着于骨的软组织增强缩窄效果，还能通过改变切除形状来改变下巴形状。外科医生应在全面评估患者术前下巴和下颌骨形态并辅以评估其审美目标的基础上定制手术。
