Jaw Angle Reduction

Q: Dr. Eppley, regarding jaw angle reduction or removal (traditional jaw angle amputation) where the surgeon cuts off the jaw angle at the mandibular ramus. Will the masseter muscle also be cut?  (looks like the masseter muscle covers this area of the bone) If the masseter muscle gets cut, then what will happen and what will be the potential consequence?

A: In jaw angle reduction surgery the masseter muscle is first lifted off the bone through subperiosteal dissection. Then the bone is cut and the muscle falls back into place during closure. Thus no muscle is cut unlike that of the bone.

While no muscle is cut during jaw angle reduction surgery, the muscle will retract upwards to the new lower border of the jaw angle when it is amputated or removed in an oblique full thickness bone cut fashion. This does not affect its function or mouth opening/closing. But between the bone removal and muscle retraction the shape and support of the soft tissues will change over the angle area. Facial width will definitely be less and hopefully there will be no soft tissue sag as a result.

Dr. Barry Eppley

Indianapolis, Indiana