Hoang Thanh Tuan, Nguyen Van Luat, Luu Dang Ai, Pham Sy Toan, Vu Quang Vinh, Tran Van Anh
Aesthetic Center, 108 Military Central Hospital, Hanoi, Vietnam.
Maxilofacial and Reconstructive Surgery Department, 103 Military Hospital, Hanoi, Vietnam.
Aesthetic Plast Surg. 2025 Sep 16. doi: 10.1007/s00266-025-05244-6.
In Asia, a square face, which is characterized by prominent mandibular angles or masseter hypertrophy, is considered less aesthetic and masculine by Oriental populations, including Vietnamese. A combination of any two procedures of mandibular ostectomy, outer cortex grinding or ostectomy, and masseter muscle resection was widely presented. In this article, we presented a single-stage procedure combining angle-body-chin curved ostectomy, corticectomy, and/or masseter muscle resection based on four classifications of mandibular angles, which brought satisfactory results in the Vietnamese population.
From January 2021 to February 2023, all cases (n = 31) that underwent facial contouring surgery only for aesthetic purposes in our clinic were included in the study. The majority of patients underwent a combination of curved ostectomy, corticectomy, and masseter muscle resection to achieve optimal results. Pre- and postoperative mandibular angles (ArGoMe), the distance between two bilateral angles (G-G), and the distance between soft tissue parts of two bilateral angles (G'-G') measured by cephalometry were recorded.
The ArGoMe angle significantly increased from 114.3° ± 3.1 to 128.7° ± 5.0 (p < 0.0001). The G-G distance and G'-G' distance statistically decreased from 97.6 ± 6.6 to 86.2 ± 4.0 mm (p < 0.0001) and from 120.7 ± 7.2 to 111.0 ± 7.2 mm (p < 0.0001). 94% of patients expressed their satisfaction with the results. No severe complications were noted.
The combination of curved mandibular ostectomy-corticectomy-masseter resection brought satisfactory results to patients with a square face and idiopathic masseter hypertrophy in both frontal and lateral views. This approach was suitable for patients with a prominent mandibular angle and masseter hypertrophy, which might be widely present in the Vietnamese population and other populations with similar anatomic characteristics.
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在亚洲，方形脸以下颌角突出或咬肌肥大为特征，包括越南人在内的东方人群认为这种脸型缺乏美感且不够阳刚。下颌骨截骨术、外板磨削或截骨术以及咬肌切除术这三种手术中的任意两种联合应用的情况被广泛报道。在本文中，我们基于下颌角的四种分类方法，介绍了一种单阶段手术，该手术联合应用角 - 体 - 颏部弧形截骨术、皮质切除术和/或咬肌切除术，在越南人群中取得了令人满意的效果。
2021年1月至2023年2月，我们诊所所有仅出于美学目的接受面部轮廓整形手术的病例（n = 31）均纳入本研究。大多数患者接受了弧形截骨术、皮质切除术和咬肌切除术的联合手术，以达到最佳效果。记录术前和术后通过头影测量法测量的下颌角（ArGoMe）、双侧角之间的距离（G - G）以及双侧角软组织部分之间的距离（G' - G'）。
ArGoMe角从114.3°±3.1显著增加至128.7°±5.0（p < 0.0001）。G - G距离和G' - G'距离在统计学上分别从97.6±6.6减小至86.2±4.0毫米（p < 0.0001）以及从120.7±7.2减小至111.0±7.2毫米（p < 0.0001）。94%的患者对结果表示满意。未观察到严重并发症。
下颌骨弧形截骨术 - 皮质切除术 - 咬肌切除术联合应用，在正面和侧面视图中均为方形脸且伴有特发性咬肌肥大的患者带来了满意的效果。这种方法适用于下颌角突出且咬肌肥大的患者，这在越南人群以及其他具有相似解剖特征的人群中可能广泛存在。
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