Malar Bone Plastic Surgery: Displaying Refined Facial Features
Cranio-maxillofacial cosmetic surgery mainly refers to various surgeries that alter the shape of the face, such as high malar bone reduction surgery, mandibular angle hypertrophy surgery (square face to oval face), and genioplasty with horizontal osteotomy (correction of a small chin), etc. These surgeries require delicate operations, advanced surgical instruments, and the surgeon must possess both an artistic aesthetic view akin to a sculptor and top-notch surgical skills. When people first started attempting these surgeries, due to limitations in instruments and lack of experience, direct incisions were often made on the skin of the face and neck to better expose the surgical area and reduce difficulty. However, this method had many shortcomings. As surgical instruments have become more refined and people's experience has grown, the above three commonly used facial contouring surgeries can now be completed solely through intraoral incisions, greatly reducing surgical risks and improving surgical outcomes.
Take the mandibular angle hypertrophy surgery as an example. The standard mandibular angle osteotomy includes intraoral incision, extraoral incision, and combined intra- and extraoral incision methods. During surgery, a micro reciprocating saw, bone chisel, or bone clamp is used to remove the thickened and enlarged mandibular angle. Each of these methods has its own range of applications and pros and cons. For instance, the intraoral incision method hides the incision well, leaving no visible surgical scars on the face but removes less bone and carries higher surgical complications (such as facial nerve trunk or branch injury causing facial paralysis or localized facial paralysis, facial artery, external carotid artery, inferior alveolar artery damage causing massive bleeding, etc.). Taking South Korea as an example, the complication rate for this surgery is 3.6%. The extraoral incision method has relatively lower complications, removes more bone, but the incision is exposed, leaving postoperative scars. Another very dangerous complication of the extraoral incision method for mandibular angle hypertrophy (square face to oval face) surgery is nerve damage. The surgery may injure the marginal mandibular branch of the facial nerve, leading to paralysis of the middle-upper part of the platysma muscle, depressor anguli oris muscle, and depressor labii inferioris muscle, resulting in facial deformity (especially during facial expressions like smiling) and asymmetry.
The intraoral incision method leaves no skin scars and is a relatively ideal surgical approach, but it must reduce the surgical risks associated with intraoral incisions and improve the surgical outcome. Now, we use an oral surgical approach, replacing the relatively more damaging and risky saws, drills, chisels, and bone clamps with a rotating burr equipped with a protective sleeve, allowing us to complete high malar bone reduction surgery, mandibular angle hypertrophy surgery, and chin shaping surgeries with high quality and low risk. This brand-new three-dimensional stereoscopic mandible shaping surgery, invented by Chinese plastic surgery experts, centers on using patented milling equipment for the mandible developed by Chinese cranio-maxillofacial plastic surgery experts to perform three-dimensional grinding and shaping of the mandible. Since the scope of mandible grinding and the amount of bone removal far exceed the traditional osteotomy range, the mandible plastic surgery effect undergoes revolutionary changes compared to traditional osteotomy. Because it completely abandons the use of reciprocating saws, bone chisels, and bone clamps, the safety of the surgery is significantly improved, and the incidence of surgical complications is only 0.11%. This new mandible plastic surgery has gradually become the standard procedure in the international plastic surgery community, replacing traditional osteotomy (i.e., Korean-style osteotomy).
This three-dimensional stereoscopic mandible shaping surgery also has a significant advantage: the surgery can be performed without general anesthesia, avoiding the risks of general anesthesia and postoperative discomfort such as laryngeal edema. This procedure can be completed under local anesthesia or intravenous sedation analgesia plus local anesthesia, eliminating the need for postoperative recovery from general anesthesia. Besides not worrying about discomfort during the operation, patients can completely avoid postoperative pain through the use of a "pain pump." The "pain pump" can continuously and minimally administer painkillers within 48 hours after surgery, keeping the patient's postoperative recovery in a pleasant state.
Five days after the surgery, the bandages can be removed, and the patient can be discharged. At this point, the swelling of the soft tissue in the surgical area has not completely subsided, and the surgical effect only shows 80-90% at this time. The best surgical results will only become apparent six months later.