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Reduction Angleplasty (Mandible Angle Reduction Surgery)

By Dr Leow Aik Ming

A prominent jaw line creates a masculine or square face appearance that may be undesirable especially in Asian females. Asian beauty emphasizes subtlety, a prominent jaw line throws off the balance of midfacial structures particularly the nose and chin by overpowering the mid face. Reducing the jaw line restores the balance and improves facial harmony. When it comes to the prominent jaw line, patients may have a significant muscle component, bone component, or both. The etiology of this condition is unknown. However, some of these conditions have been associated with ethnicity which are commonly seen in East Asian descendents, masseter muscle hypertrophy (jaw muscle overgrowth) as a result of habitual jaw clenching, teeth grinding or diet (dried squid, tough and chewy delicacies).

Reduction angleplasty or mandibular angle reduction surgery is a cosmetic surgical procedure done to transform a square shaped face to a more delicate and feminine facial appearance. This surgical procedure is effective in correcting prominent body and angle of the lower jaw, thus reducing the width of lower face and changing a square face to an oval or “V” shaped face. In some cases, mandible angle reduction surgery is combined with other facial contouring surgeries such as zygoma reduction, messeter muscle reduction or genioplasty to achieve facial balance. Mandible angle reduction surgery is often performed through intraoral approach hence there is no visible scar externally.

Patients who seek mandibular angle reduction surgery usually have a desire to improve their appearance and they should not attempt to mimic the appearance associated with Caucasian facial features.  Preservation of ethnicity remains the cornerstone of this surgery and patient should have realistic expectations from the surgery.

Preoperative evaluation for mandibular angle reduction surgery:

  • Discussion about patients’ expectations and desired outcome
  • Medical conditions, drug allergies and previous medical or surgical treatment
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries
  • Examination of the face and its soft tissues
  • Radiological assessment (CT scan of face)
  • Preoperative evaluation for general anaesthesia
  • Photography for preoperative and postoperative evaluation

Postoperative expectations:

Following mandibular angle reduction surgery, drains (tubes to remove excess blood) may be removed after the second postoperative day. During the initial healing phase, patient may experience pain, numbness, bruises and swelling around the lower jaw. These symptoms usually fade away after 3-4 weeks. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively.

Postoperative care:

  • Follow the postoperative instructions given carefully
  • Head elevation especially when sleeping for 3-4 weeks
  • Take the prescribed medications as instructed
  • Cold compressive dressing around the lower jaw might be used for 3-7 days
  • Regular mouthwash or gargle after every meal if there are any oral wounds
  • Soft diet for 2-3 weeks
  • Avoid strenuous physical activities for 3-4 weeks
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