3 Facial Contouring Methods: Is It Just About Shaving Down the Bone?
- Even with the same cheekbones, osteotomy and ostectomy differ depending on bone position.
- Osteotomy is a method of cutting the bone and repositioning it; realignment is key.
- Ostectomy is a method of shaving down the bone; only the protruding part is removed.
"Shaving Off Bone"? It's Actually Divided into Three Methods
Osteotomy accounts for 70% of contouring surgery. We cut the bone and push it inward. Resection involves grinding down the bone, while advancement surgery involves moving the entire jawbone. Even with cheekbone surgery, the method varies depending on where the bone protrudes. If the side of the cheek is wide, osteotomy is used; if the front is wide, resection is performed.Osteotomy: Cutting and Repositioning Bone
The cheekbone is cut in an L-shape and then pushed inward and backward before being fixed. The bone itself remains, but its position is changed. Recovery takes 4-6 weeks, and a fixation period is necessary. The same applies to the jaw angle. The mandibular angle is cut horizontally to reduce the angle and fixed with a titanium plate. Hard foods should be avoided while the bone heals.Clinical Insight It takes at least 6 weeks for bone to fuse after osteotomy. If impacted during this period, the fixation position can be disturbed.
True or False Quiz
Cheekbone osteotomy involves grinding down the bone.
Check the answer
False Osteotomy involves cutting the bone and repositioning it. Grinding the bone is done in resection surgery. Osteotomy requires a fixation period but offers significant changes.
Resection: Grinding Down Only the Protruding Part
This method is used for wide frontal cheekbones or angular jaw tips. Since it involves grinding the bone, recovery is 2 weeks faster than osteotomy. However, the thickness that can be removed is limited to about 5mm. For jaw angle resection, the outer side of the mandibular angle is shaved vertically. Unlike osteotomy, no fixation devices are needed, resulting in less swelling. However, the jawline angle itself doesn't change as much as with osteotomy.| Method | Applicable Area | Recovery Period | Degree of Change |
|---|---|---|---|
| Osteotomy | Side of cheekbone, jaw angle | 4-6 weeks | Large |
| Resection | Front of cheekbone, jaw tip | 2-4 weeks | Moderate |
| Advancement | Jaw tip, underbite | 6-8 weeks | Very Large |
Recovery periods may vary individually and depend on the scope of the surgery.
Advancement Surgery: Moving the Entire Jawbone
This procedure is performed for short jaws or underbites, where the jawbone is cut horizontally and then moved forward or backward. Since it affects the bite, it's often done in conjunction with orthodontic treatment. Recovery takes 6-8 weeks, the longest duration. The advancement distance is an average of 5-8mm (Korean Association of Oral and Maxillofacial Surgeons, 2022). Moving more than 10mm increases the risk of nerve damage, so the nerve's position is first confirmed via CT scan.- Nerve damage rate 1-3%, proportional to advancement distance
- Orthodontic treatment may be required for bite changes
Finding the Right Method for You
Wide side cheekbones and angular jaw
Cheekbone osteotomy + Jaw angle osteotomy
Repositioning bone is highly effective for lateral protrusion.
Wide front cheekbones, but acceptable angle
Cheekbone resection
Fast recovery and sufficient for reducing frontal width.
Misconceptions Debunked
Myth All contouring surgeries involve shaving off bone.
Truth Osteotomy involves cutting and repositioning bone. Resection involves grinding, and they are applied to different areas.
Must Check Before Surgery
- !!Mandatory CT scan to check nerve position!! — Damage to the inferior alveolar nerve can cause lip sensation loss for over 6 months.
- !!Check blood pressure and diabetes control!! — Increases the risk of bleeding and infection during surgery.
- !!Stop smoking and drinking 2 weeks before surgery!! — Slows bone healing and increases the risk of inflammation.
Frequently Asked Questions
Which is safer, osteotomy or resection?
Resection has a faster recovery, but the nerve damage rates are similar. Safety is more dependent on the surgeon's experience and CT planning.
Doesn't the bone grow back after surgery?
Resected bone does not regenerate. Osteotomized bone fuses and attaches at the repositioned site.
What are the symptoms of nerve damage?
Numbness or loss of sensation in the lips and chin. Most cases recover within 3-6 months, but permanent damage is reported in about 1% of cases.
References
- Incidence and Recovery Course of Nerve Injury After Facial Contouring Surgery — Korean Association of Oral and Maxillofacial Surgeons, 2022
- Orthognathic Surgery Guidelines — Korean Association of Oral and Maxillofacial Surgeons, 2023
Lumi's Insight
Osteotomy, resection, advancement – the names can be confusing. Remember this: where the protrusion is determines the method. A CT scan holds the answer. If you're unsure, start your consultation by asking, "Where is my bone protruding from?"
This content is for informational purposes only and does not substitute for medical advice. Always consult with a specialist before undergoing any procedure.
