Is It Possible To Do Just A Little V Line Surgery But Not Too Much?
Q: Dr. Eppley, I’m considering undergoing V-line surgery but I’m afraid if I do I’ll get an overly oval/egg shaped face with a jaw that is too narrow. Is it possible to get V-line surgery just to change the height of the ramus and with some overall narrowing but not too much?
In particular, I dislike how low my jaw/gonial angles are in relation to my mouth; I would like my jaw to have more of a V-shape but with higher jaw angles, like in the picture I attached. I have also attached my own photo.
A: You are wise to be concerned about V line surgery for your facial goals for the following reasons:
1) The way V line surgery has to be done due to the intraoral approach and the use of 90 degree saw angle is a major vertical jaw angle reduction. It is technically impossible to just due a ‘little’ vertical jaw angle reduction and/or keep some jaw angle shape. This is a relatively drastic jaw reduction procedure when it comes to most Caucasians faces and lower jaw shapes. So the concept of ‘not too much’ jaw reduction is usually not a realistic one.
2) Postoperative regret amongst Caucasian V line surgery patients is much higher than in Asian V line surgery patients.
3) The ideal image you have shown compared to your face is probably not a realistic change. Plus your face picture is taken straight one while the ideal one is tilted down…that little change makes a big difference in its appearance.
4) Patients often overlook the fact that the face is a 3D structure. How it may be seen in one view (in this case the front view) may be very different from other angles. (side or oblique views) So even if that type of change was possible you may very well dislike how it looks in other views…. a common postoperative ‘finding’ by some patients.
5) You may find that reduction of the width of your jaw angles only may achieve the lower facial shape change you desire without the negative aesthetic effects of traditional V line surgery. This is often effective in patients that don’t want too much of a change to the jaw angle region of their lower face.
Dr. Barry Eppley