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The prominent mandibular angle: preoperative management, operative technique, and results in 42 patients

In 42 women who had a prominent jaw angle reduced for cosmetic reasons, mostly through the mouth with an oscillating saw, results were generally satisfactory, with one inaccurate bone cut and three infections that resolved without lasting effects.

1989
Plast Reconstr Surg
126
Citations, NIH iCite
3
Authors
0
Topics

Overview

A prominent jaw angle gives the face a square, muscular look. The authors state it is considered unattractive in the Orient (their term) and is described infrequently in the United States. They retrospectively reviewed 42 female patients who asked for jaw angle reduction, and describe their planning and surgical method.

Findings

  • Retrospective study of 42 female patients requesting cosmetic reduction of a prominent mandibular angle.
  • Planning used formal planimetry, cephalometric tracings and Panorex jaw X-rays.
  • Surgery used the intraoral approach, with an oscillating saw to remove a planned segment of bone.
  • Muscle was also resected in 18 of 42 patients.
  • One patient having a face lift at the same time had the reduction through a preauricular incision.
  • Cosmetic results were generally satisfactory.
  • One inaccurate osteotomy.
  • Three infections, all resolved without sequelae.

What it means for a patient

  • A square lower face from a wide jaw angle can be narrowed by removing bone, and sometimes muscle, usually through the inside of the mouth.
  • In one case the bone was reached through the face lift incision in front of the ear during a face lift.
  • In this series, 3 of 42 patients had an infection and 1 had an inaccurate bone cut.
  • Limits: a retrospective series of 42 women, results described as "generally satisfactory" without a measured scale, and no follow-up length given in the abstract.

Why this paper matters

It set out a planning and surgical method for jaw angle reduction and reported results in 42 patients. It also records the use of a face lift incision to reach the jaw angle in a combined procedure. Cited 126 times (NIH iCite, 2026-09-25).

Terms

  • Mandibular angle: the corner of the lower jaw below the ear.
  • Planimetry: measuring areas on a flat drawing or photograph to plan surgery.
  • Cephalometric tracing: a drawing made from a side-view skull X-ray to measure facial bones.
  • Panorex: a panoramic X-ray that shows the whole jaw in one image.
  • Intraoral approach: surgery through an incision inside the mouth, leaving no skin scar.
  • Oscillating saw: a powered saw whose blade moves side to side to cut bone.
  • Osteotomy: a controlled cut through bone.
  • Preauricular incision: a cut in front of the ear, as used in a face lift.

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