As the size and format of the human face are mainly determined by the facial skeleton, any abnormalities of the underlying bone structure will reflect on the external soft tissue. Surgical procedures altering the craniofacial bone framework have a significant effect on facial appearance, and can contribute to facial aesthetic enhancement up to some degree (HSU et al., 2010). The square jaw with low angle deformity, commonly referred to as “square face”, is defined by a gonial angle between 120 and 90 degree accompanied by a mandibular plane angle lower than 30 degrees, resulting in a face with a flat mandibular outline (HSU et al, 2010). The prominent mandibular angle is a common facial trait throughout the world, but is especially prevalent in Asian countries. When combined with masseteric hypertrophy, it results in a characteristic “square face” (DEGUCHI et al., 1997). Causes of prominent mandibular angle have been ascribed to hereditary conditions and parafunctional habits such as bruxism and unilateral chewing for long periods (GUI et al., 2005). While the presence of a prominent mandibular angle …show more content…
Mandibular angle reduction with an oscillating saw via the intraoral approach became the primary technique for reduction mandibuloplasty. While mandibular angle ostectomy may improve the contour of the mandibular angle from a lateral perspective, it does not narrow the mandible effectively from an anterior view; therefore, mandibular angle-splitting ostectomy and other refined surgical procedures were developed to maximize the aesthetic effect in the frontal view (DEGUCHI et al., 1997). A combined approach naturally followed, with mandibular angle resection performed concomitantly with angle-splitting ostectomy, enabling narrowing of the lower face and improvement of the mandibular plane with a single procedure (HWANG et al.,