Malar Bone Plastic Surgery to Reveal Delicate Features
Cranio-maxillofacial cosmetic surgery mainly refers to various surgeries that alter the shape of the face, such as malar bone reduction surgery, mandibular angle hypertrophy surgery (square face to oval face), genioplasty (correction of a small chin), etc. These surgical operations are delicate and require excellent surgical instruments. The operator must possess both an artistic aesthetic sense akin to a sculptor and top-notch surgical skills. When people first began attempting these surgeries, due to limitations in instruments and lack of experience, it was often necessary to make direct incisions on the skin of the face and neck to better expose the surgical area and reduce difficulty. This method had many shortcomings. As surgical instruments improved and became increasingly refined, and with people's experience gradually growing richer, the aforementioned three commonly used facial contouring surgeries can now be completed solely through intraoral incisions, greatly reducing the risks of surgery and improving surgical outcomes.
Take mandibular angle hypertrophy surgery as an example. Conventional mandibular angle osteotomy includes intraoral incision methods, extraoral incision methods, and combined intraoral and extraoral incision methods. During surgery, micro reciprocating saws, bone chisels, or bone forceps are used to remove the thickened and enlarged mandibular angle. Each of these methods has its applicable scope and advantages and disadvantages. For instance, the intraoral incision method hides the incision, leaving no visible surgical marks on the face, but less bone is removed, and the rate of surgical complications is higher (such as injury to the main trunk or branches of the facial nerve causing facial paralysis or localized facial paralysis, damage to the facial artery, external carotid artery, or inferior alveolar artery leading to severe bleeding, etc.). In South Korea, for example, the complication rate of this surgery is 3.6%. The extraoral incision method has relatively lower complications, removes more bone, but leaves visible scars after surgery. 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, causing paralysis of the middle and upper parts of the platysma muscle, depressor anguli oris muscle, and depressor labii inferioris muscle, resulting in facial deformity (especially when making facial expressions like smiling) and asymmetry.
The intraoral incision method does not leave skin scars and is a relatively ideal surgical approach, but it is necessary to reduce the surgical risks associated with the intraoral incision method and improve the surgical outcome. Now, we use an intraoral surgical approach, replacing saws, drills, chisels, and bone forceps, which have relatively greater damage and risk, with rotating milling files equipped with protective sleeves. This allows us to complete high malar bone reduction surgery, mandibular angle hypertrophy surgery, and chin shaping surgeries with high quality and low risk. This new type of three-dimensional jawbone shaping surgery, invented by Chinese plastic surgery experts, uses patented milling equipment developed by Chinese maxillofacial plastic surgery experts to perform three-dimensional grinding and shaping of the jawbone. Since the range of jawbone grinding and the amount of bone removal far exceed the osteotomy range of traditional osteotomy, the effect of jawbone plastic surgery has undergone revolutionary changes compared to osteotomy. Because it completely abandons the use of reciprocating saws, bone chisels, and bone forceps, the safety of the surgery has significantly increased, and the incidence of surgical complications is only 0.11%. This new type of jawbone plastic surgery has gradually become the standard procedure in the international plastic surgery field, replacing traditional osteotomy (i.e., Korean-style osteotomy).
This three-dimensional jawbone shaping surgery also has a significant advantage: the surgery can be performed without general anesthesia, avoiding the risks and discomforts of general anesthesia, such as postoperative 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. Patients do not need to worry about discomfort during the surgery, and postoperatively, through the use of "pain pumps," postoperative pain can be completely avoided. The "pain pump" can continuously and minimally administer pain medication for 48 hours post-surgery, keeping patients in a pleasant state during their recovery.
Five days after the surgery, the bandages can be removed, and the patient can be discharged from the hospital. At this time, the swelling of the soft tissues in the surgical area has not completely subsided, and the effect of the surgery is only 80-90% visible. The best surgical results will only be evident six months later.