Why Did Jaw Angle Reduction Surgery Not Make My Face Slimmer?

Q: Dr. Eppley, I had jaw angle reduction surgery last year. I told the surgeon I wanted my jaw slightly slimmer, but I said I wanted to keep the same shape and definition of my jaw.  However, there does not seem to be any difference in the width of my jaw, but unfortunately my jaw angle slopes now, whereas before I had a nice defined jaw angle. I didn’t want to lose the jaw angle, just some of the width. From the front I look basically the same, although I had been hoping for a slightly slimmer lower face, but from the side and 3/4 view of my face, I have lost my nice jaw angle definition, which was what I wanted to keep. Was what I was requesting impossible? Thank you in advance for any insight you can provide. 

A: I can not tell you whether what you were asking was impossible as I have no idea what your face looked like before your surgery or looked like now. But I can give you some insight about jaw angle reduction. There are two basic techniques and they are done differently. Width reduction of the jaw angle is done by removing the outer cortex of the bone, either by a split osteotomy or burring reduction. Amputation of the jaw angle removes the tip of it, which make reduce width but will also shorten it vertically as well. What technique you had done is unknown to me but it sounds from the result that it may have been more of an amputation approach.

Whatever the jaw angle reduction technique that is decided on before surgery, it is first necessary to see an x-ray of the jaw angles to see how much flare they have and its thickness. That information will help determine if the procedure, regardless of the proper technique, actually has a chance to make a visible difference. This would be of particular importance in the width reduction jaw angle approach as the thickness of the bone determines whether enough can be removed to justify the effort.

Dr. Barry Eppley

Indianapolis, Indiana