Can Jaw Angle Lengthening be Done By Cutting The Bone?
Q: Dr. Eppley,, is it possible to vertically advance the bottom jaw via the ramus? I understand that most surgeries involving the ramus are used to correct jaw asymmetries but I would simply like to lower the position of my bottom jaw as it is poorly positioned and makes my face appear crowded to the centre. Is that possible? And if it is I would like to pair that surgery with a Lefort 1 or 2 and genioplasty or other chin advancement surgery.
A: If I understand your question I believe you are referring to doing a horizontal osteotomy and vertically lengthening the ramus. (jaw angle lengthening) While this is surgically possible there are several technical issues that make its use very limited…it would require an external skin incision, plate fixation and a bone graft to do so. Such an effort seems aesthetically adverse when there are simpler alloplastic methods to accomplish the same effect.
However the broader question of how ramus lengthening fits in with a LeFort and sliding genioplasty procedures is not a question that can be answered without pictures, x-ray and dental analysis.
Dr. Barry Eppley