Q: Dr. Eppley, My surgeon indicated that he wants to perform a mandibular osteoplasty to reduce the squareness of my angles; this is why he would need to use screws. He told me that the bone is so hard to reach that he doesn’t use the angles osteotomy, he doesn’t know how to do that. He is a maxillofacial surgeon and not a facial feminization surgeon.
Are you aware of the mandibular osteoplasty surgery? Is that appropriate to reduce mandibular angles? Does that give a more natural result to the angles? One that causes less asymmetry or sagging skin? Is a maxillofacial surgeon appropriate for that type of surgery? (purely aesthetic as I have no functional problems)
A: The term, mandibular osteoplasty, is a generic term (means jaw bone reshaping) that does not imply any specifics about the surgical technique. You would have to ask him to draw exactly what this technique is to understand what is being proposed. However, I suspect he is talking about doing a sagittal split ramus osteotomy as this would be the only jaw angle procedure in which screws would be used to fix the bone back together. I do not see any reason or indication in this approach for what you are trying to achieve aesthetically. I suspect you are correct in that this particular maxillofacial surgeon is taking a functional rather than an aesthetic approach to your concerns.
Dr. Barry Eppley