Facial Bone Contouring Surgery: A Practical Guide

Preface for Second Edition
Contents
Contributors
Part I: General
	1: Evolution of Facial Bone Contouring Surgery
		1.1	 Beauty Is Bone-Deep
		1.2	 Beautiful Facial Structure
		1.3	 Studies on Facial Structure
		1.4	 Beauty Keeps Changing
		1.5	 Introduction of Aesthetic Facial Bone Surgery
		1.6	 Why Facial Bone Surgery Became So Popular in Asia?
		1.7	 Medical and Technical Advances Lower the Huddle
		1.8	 Evolving Understanding of Facial Bone Structure Improves Strategies
		1.9	 Why Global?
		1.10	 Surgeon’s Mission
		References
	2: Anatomic Basis for Facial Bone Contouring Surgery
		2.1	 Pearls
		2.2	 Introduction
		2.3	 Nerves
			2.3.1	 Inferior Alveolar Nerve (Fig. 2.1)
			2.3.2	 Infraorbital Nerve (Fig. 2.2)
			2.3.3	 Zygomaticotemporal/Zygomaticofacial Nerve (Fig. 2.2)
			2.3.4	 Facial Nerve (Fig. 2.3)
		2.4	 Vessels
			2.4.1	 Facial Artery (Fig. 2.3)
			2.4.2	 Facial Vein (Fig. 2.3)
			2.4.3	 Retromandibular Vein
		2.5	 Muscles
			2.5.1	 Mentalis Muscle (Fig. 2.4)
			2.5.2	 Buccinator Muscle (Fig. 2.4)
		2.6	 Fat
			2.6.1	 Buccal Fat Pad (Fig. 2.5)
		2.7	 Conclusion
		References
	3: Basic Approaches for Facial Bone Contouring Surgery
		3.1	 Pearls
		3.2	 Introduction
		3.3	 Surgical Approaches
			3.3.1	 Intraoral Approach
				3.3.1.1	 Maxillary Vestibular Approach
				3.3.1.2	 Mandibular Vestibular Approach
			3.3.2	 Bicoronal Approach
			3.3.3	 Transcutaneous Approach
				3.3.3.1	 Sideburn Approach
				3.3.3.2	 Gillies’ Approach
			3.3.4	 Periorbital Approach
				3.3.4.1	 Subciliary Incision
				3.3.4.2	 Transconjunctival Incision
		3.4	 Key Technical Points
		References
	4: Customized Instruments for Facial Bone Contouring Surgery
		4.1	 Pearls
		4.2	 Introduction
		4.3	 Surgical Instruments
			4.3.1	 Zygoma Reduction
			4.3.2	 Mandible Reduction
			4.3.3	 Genioplasty
		4.4	 Discussion
		References
Part II: Lower Face
	5: The Comprehensive Aesthetic Analysis for Lower Face
		5.1	 Pearls
		5.2	 Introduction
		5.3	 Patient Consultation and Assessment
			5.3.1	 Patient Selection and Consultation
			5.3.2	 Clinical Evaluation
			5.3.3	 Radiologic Evaluation
				5.3.3.1	 Frontal Plane Analysis
				5.3.3.2	 Sagittal Plane Analysis
				5.3.3.3	 Transverse Plane Analysis
		5.4	 Consideration in Surgical Planning
			5.4.1	 Chin
			5.4.2	 Evaluating Abnormal Skeletal Relationships Between the Maxilla and Mandible
			5.4.3	 Asymmetry
			5.4.4	 Soft Tissue Contribution
			5.4.5	 Ethnic Variation and Cultural Background
		References
	6: The Standard Mandible Reduction with Intraoral Approach
		6.1	 Pearls
		6.2	 Introduction
		6.3	 Patient Assessment
			6.3.1	 Frontal Plane
			6.3.2	 Sagittal Plane
			6.3.3	 Transverse Plane
		6.4	 Surgical Technique
		6.5	 Key Technical Points
		6.6	 Case Study
		6.7	 Complications and Management
			6.7.1	 Hemorrhage and Hematoma
			6.7.2	 Nerve Injury
			6.7.3	 Infection and Inflammation
		6.8	 Discussion
			6.8.1	 Approach: Intraoral Versus External Approach
			6.8.2	 Types of Ostectomy: Curved Ostectomy Versus Tangential Ostectomy (Fig. 6.7)
				6.8.2.1	 Curved Ostectomy with an Oscillating Saw
				6.8.2.2	 Tangential Ostectomy with a Reciprocating Saw (Lateral Cortex Ostectomy)
				6.8.2.3	 Asymmetry
				6.8.2.4	 Soft Tissue Contribution
				6.8.2.5	 Ethnic Variation and Cultural Background
				6.8.2.6	 Abnormal Skeletal Relationship Between the Maxilla and Mandible
		References
	7: The Current Concepts of Sagittal Resection of the Mandible
		7.1	 Pearls
		7.2	 Introduction
		7.3	 Patient Assessment and Consultation
		7.4	 Surgical Techniques
		7.5	 Case Study
		7.6	 Complications and Management
			7.6.1	 Nerve Injury
		7.7	 Discussion
		References
	8: The Basic Principles in Osseous Genioplasty
		8.1	 Pearls
		8.2	 Introduction
		8.3	 Patient Assessment
		8.4	 Surgical Technique
		8.5	 Key Technical Points
		8.6	 Case Study
		8.7	 Complications and Management
			8.7.1	 Neurosensory Deficits
			8.7.2	 Deepened Labiomental Sulcus and Mentalis Overaction
			8.7.3	 Step Deformities and Border Irregularities
			8.7.4	 Asymmetry
			8.7.5	 Chin Ptosis
		8.8	 Discussion
		References
	9: V-Logic Principle for Genioplasty: Logical Approach for Balanced Chin
		9.1	 Pearls
		9.2	 Introduction
		9.3	 Patient Assessment and Consultation
			9.3.1	 Diagnosis
			9.3.2	 Preoperative Evaluation and Surgical Planning
			9.3.3	 Consideration in Surgical Planning
		9.4	 Surgical Techniques
			9.4.1	 Basic Osteotomy
			9.4.2	 Types of Genioplasty
			9.4.3	 Patients with Normal Nerve Anatomy
				9.4.3.1	 Classic T Osteotomy
				9.4.3.2	 Two-Parallel Osteotomy
				9.4.3.3	 Bow Tie-Shaped Osteotomy
				9.4.3.4	 Diamond-Shaped Osteotomy
			9.4.4	 Patients with Low Nerve Anatomy
				9.4.4.1	 Inverted V-Shaped Osteotomy
				9.4.4.2	 Spade-Shaped Osteotomy
				9.4.4.3	 Bird-Shaped Osteotomy
				9.4.4.4	 Diamond-Shaped Osteotomy + Inverted V-Shaped Osteotomy
		9.5	 Case Study
		9.6	 Discussion
		References
	10: The V-Line Surgery: Narrowing Genioplasty with Mandible Reduction
		10.1	 Pearls
		10.2	 Introduction
			10.2.1	 Classification of Chin
		10.3	 Patient Assessment
		10.4	 Surgical Techniques
		10.5	 Key Technical Points
		10.6	 Case Study
		10.7	 Complications and Management
			10.7.1	 Neurosensory Deficits
			10.7.2	 Hemorrhage
			10.7.3	 Unsatisfactory Chin Shape
			10.7.4	 Double Contour in Geniomandibular Junction
		10.8	 Discussion
		References
	11: The Mini V-Line Surgery
		11.1	 Pearls
		11.2	 Introduction
		11.3	 Surgical Technique
		11.4	 Key Technical Points
		11.5	 Case Study
		11.6	 Complications and Management
		11.7	 Discussion
		References
	12: Consideration in Treatment of Long Face
		12.1	 Pearls
		12.2	 Introduction
		12.3	 Patient Assessment and Consultation
		12.4	 Surgical Techniques
			12.4.1	 Reduction Genioplasty
				12.4.1.1	 Two-Parallel Osteotomy
				12.4.1.2	 Inverted V-Shaped Osteotomy
				12.4.1.3	 Spade-Shaped Osteotomy
				12.4.1.4	 Bow Tie-Shaped Osteotomy
		12.5	 Philtrum Reduction
		12.6	 Key Technical Points
		12.7	 Case Study
		12.8	 Complication and Management
		12.9	 Discussion
		References
	13: Alloplastic Modification of Lower Face
		13.1	 Pearls
		13.2	 Introduction
		13.3	 Patient Assessment and Consultation
		13.4	 Surgical Techniques
			13.4.1	 Chin
			13.4.2	 Mandibular Implant
		13.5	 Key Technical Points
		13.6	 Case Study
		13.7	 Complication and Management
			13.7.1	 Infection
			13.7.2	 Malposition
			13.7.3	 Bony Resorption
		13.8	 Discussion
		References
	14: Secondary Mandibular Contouring Surgery
		14.1	 Pearls
		14.2	 Introduction
		14.3	 Case Study
		References
	15: Soft Tissue Surgery Combined with the Mandible Contouring Surgery
		15.1	 Pearls
		15.2	 Introduction
		15.3	 Patient Assessment and Consultation
		15.4	 Surgical Techniques
			15.4.1	 Laser-Assisted Liposuction
			15.4.2	 Barbed Suture Lift
			15.4.3	 Elastic Lift
		15.5	 Facelift
		15.6	 Key Technical Points
		15.7	 Case Study
		15.8	 Complications and Management
			15.8.1	 Skin Depression and Palpability
			15.8.2	 Neurapraxia
			15.8.3	 Infection
		15.9	 Discussion
		References
Part III: Midface
	16: The Comprehensive Aesthetic Analysis for Midface
		16.1	 Pearls
		16.2	 Introduction
		16.3	 Patient Consultation and Assessment
			16.3.1	 Preoperative Analysis
				16.3.1.1	 Frontal Evaluation
				16.3.1.2	 Three-Quarter Oblique Evaluation
					Hinderer Analysis
					Wilkinson Analysis
				16.3.1.3	 Basal Evaluation
				16.3.1.4	 Basic Concept and Strategy for Classification of Zygoma
					Zygomatic Arch
					Zygomatic Body
				16.3.1.5	 Classification of Zygomatic Prominence (Fig. 16.5)
				16.3.1.6	 Surgical Strategy and Details (Fig. 16.6)
			16.3.2	 Additional Considering Points
				16.3.2.1	 Soft Tissue Contribution
				16.3.2.2	 Asymmetry and Facial Balance
		16.4	 Discussion
		References
	17: Standard Zygoma Reduction with Intraoral Approach
		17.1	 Pearls
		17.2	 Introduction
			17.2.1	 Reduction of Facial Width
			17.2.2	 Change a Boxy Facial Contour into a Three-Dimensional Contour
			17.2.3	 Attain a Smooth Facial Line
		17.3	 Patient Assessment and Consultation
		17.4	 Zygomatic Body Analysis
			17.4.1	 Hinderer Analysis
			17.4.2	 Wilkinson Analysis
		17.5	 Zygomatic Arch Analysis
		17.6	 Midfacial Soft Tissue
		17.7	 Surgical Techniques
			17.7.1	 Anesthesia and Approach
			17.7.2	 Anterior Osteotomy
			17.7.3	 Posterior Osteotomy
			17.7.4	 Fixation
		17.8	 Key Technical Points
		17.9	 Case Study
		17.10	 Complications and Management
		17.11	 Discussion
		References
	18: The Reduction Malarplasty with Coronal Approach
		18.1	 Pearls
		18.2	 Introduction
		18.3	 Patient Assessment
		18.4	 Surgical Technique
		18.5	 Key Technical Points
		18.6	 Complications and Management
		18.7	 Discussion
		References
	19: Extended Zygomatic Reduction for Orbital Rim Protrusion
		19.1	 Pearls
		19.2	 Introduction
		19.3	 Patient Assessment and Consultation
		19.4	 Surgical Techniques
			19.4.1	 Tripod Osteotomy
			19.4.2	 Orbital Rim Shaving
		19.5	 Key Technical Points
		19.6	 Case Study
		19.7	 Complications and Management
		19.8	 Discussion
		References
	20: The Mini-Zygoma Reduction Surgery
		20.1	 Pearls
		20.2	 Introduction
		20.3	 Patient Assessment
		20.4	 Surgical Technique
		20.5	 Key Technical Points
		20.6	 Case Study
		20.7	 Complications and Management
		20.8	 Discussion
		References
	21: Alloplastic Modification of the Midface
		21.1	 Pearls
		21.2	 Introduction
		21.3	 Patient Assessment and Consultation
		21.4	 Surgical Techniques
		21.5	 Key Technical Points
		21.6	 Case Study
		21.7	 Complications and Management
			21.7.1	 Infection
			21.7.2	 Sensory Disturbance
			21.7.3	 Migration of Implant
			21.7.4	 Asymmetry
		21.8	 Discussion
			21.8.1	 Hard Implant Versus Soft Tissue Augmentation
			21.8.2	 Host-Implant Interaction
			21.8.3	 Immobilization
		References
	22: Secondary Zygoma Reduction
		22.1	 Pearls
		22.2	 Introduction
		22.3	 Patient Assessment
		22.4	 Surgical Technique
		22.5	 Cases
		22.6	 Complications and Management
		22.7	 Discussion
		References
	23: Soft Tissue Surgery Combined with Zygoma Reduction
		23.1	 Pearls
		23.2	 Introduction
		23.3	 Patient Consultation and Assessment
			23.3.1	 Preoperative Evaluation
			23.3.2	 Patient Selection
				23.3.2.1	 Lowering Lateral Canthoplasty (LLC)
				23.3.2.2	 Midface Lifting Procedure
		23.4	 Surgical Technique
			23.4.1	 Lowering Lateral Canthoplasty Combined with Zygomatic Reduction
			23.4.2	 Endotine Midface Lifting Combined with Zygomatic Reduction
			23.4.3	 Mini-lifting Combined with Zygomatic Reduction
		23.5	 Cases
		23.6	 Discussion
		References