Square Jaw Surgery

First, we will show you the basic information.

Square jaw surgery cuts away the corner of the lower jawbone in a curve and, if needed, thins the outer bone on the side of the jaw to refine the jawline.

In a word, it is surgery that looks at and refines both the angle of the jaw corner seen from the side and the width of the jaw seen from the front.

The width of the lower face seen from the front is determined by how far the corners of the jaw flare outward. The angular look seen from the side is determined by how sharply the corner bends.

If the parts that bother you differed between your front photo and your profile photo, this difference is the reason.

It is done when the bone at the corner of the lower jaw is angular and flares outward, so the lower face looks wide and angular.

As you read the list below, picture the jawline in your mirror. If any of it applies, we check at the consultation whether square jaw surgery is right for you.

• When, from the front, the corners of the jaw flare outward and the face looks square
• When, from the side, the corner of the jaw below the ear looks sharply angled
• When you often hear that the corners of your jaw are large and give you a strong impression

We do not recommend surgery right away just because something applies. Not every wide jaw is caused by bone. The first of our treatment principles is "We never recommend excessive surgery." If muscle or another cause is the larger factor, we will tell you so.

A Word from the Doctor

"Bone surgery should not be done automatically just because the face looks large and wide; the most important thing is to perform the surgery that is needed after an accurate diagnosis."

When the cause of the wide jaw is muscle

If the corner of the jaw rises firmly when you clench your back teeth, the chewing muscles may be larger than the bone.

You can get a rough idea by clenching your back teeth once in front of a mirror. The exact distinction is made by examination, as described below.

At our clinic, we often recommend first reducing the volume with Botox injections rather than surgery that directly cuts away the masseter.

Whether the bone or the muscle is larger is determined by examination and CT (a scan that images the bone in three dimensions). Injections to reduce the muscle are explained in the Botox procedure information.

If the reason the jawline has become blurred is sagging rather than bone, surgery to lift the sagging may come before square jaw surgery.

If you feel that your jawline is not what it used to be, this is something you should be sure to consider before deciding on surgery.

That is why, in consultations with middle-aged patients, we look at the degree of sagging of the jawline and neck together with the shape of the jawbone. If the reason the jawline has become blurred is sagging, see the Facelift surgery information and the Neck lift surgery information first; if the area under the chin is loose, see the Double chin muscle tightening surgery information first.

The usual method is to make an incision in the gum outside the lower molars inside the mouth, cut away and refine the bone at the corner of the jaw, and then close the incision with sutures (stitches).

When surgery is done through the inside of the mouth, no scar is left on the outside of the face. In exchange, the bone is cut while viewed through a narrow incision in the mouth, so it is important to confirm the positions of the nerves and blood vessels in advance through planning and CT.

Our clinic's basic method is to cut the bone in a long curve from the corner of the jaw to the side of the jaw toward the front (long curved resection). When the width seen from the front needs to be reduced further, the outer bone plate on the side of the jaw (the lateral cortex) is additionally thinned away. Because of the risks of bleeding and nerve injury, we tend not to cut the chewing muscle (masseter) directly, and if muscle volume remains, we recommend reducing it with Botox. Square jaw surgery only cuts the bone away and does not move it to another place, so no fixation hardware such as metal plates or screws is used.

The anesthesia is general anesthesia, and the operating time is 1 hour to 1 hour 30 minutes. You stay in the hospital for a day after surgery.

Tests for general anesthesia are done before surgery. An anesthesiology and pain medicine specialist administers the anesthesia. You fast for 8 hours before surgery. You may not drink even water.

Since it is your first time, it may feel unclear, so we have laid it out in order below.

1. Consultation and planning

Using facial photographs and CT, we look at the shape of the jawbone, left-right differences, and the course of the nerves. Please tell us about all the medications you take and any conditions you have. Even things that seem trivial are fine. Tests for general anesthesia are done before surgery.

2. Anesthesia

An anesthesiology and pain medicine specialist administers general anesthesia. When you wake up, the surgery is already over.

3. The incision is made inside the mouth and the bone is cut

An incision is made in the gum outside the lower molars, and the bone is cut away along the planned line, in a long curve from the corner of the jaw to the side of the jaw toward the front. If the width seen from the front needs to be reduced further, the outer bone plate on the side of the jaw (the lateral cortex) is additionally thinned away.

4. The bone edges are smoothed and bleeding is stopped

The edges of the cut bone are smoothed and the bleeding is stopped. Because the bone is not repositioned and fixed, no metal plates or screws are used.

5. The incision is closed and compression is applied

The incision inside the mouth is closed with sutures, and a compression band is wrapped around the face and jaw to reduce swelling and bleeding. You stay in the hospital for a day after surgery.

You can usually return to daily life to some extent 1 to 2 weeks after surgery. Swelling lasts longer than that: most of the major swelling goes down during the first month, and the remaining swelling goes down slowly over several months while the jawline settles.

If you have work or an important appointment coming up, this is probably what you most want to know. We have written it by time point.

1. The first few days

   Swelling is at its worst. Bruising may extend down to the neck

2. 1 to 2 weeks

   By this time you can usually return to daily life to some extent. While the wound inside the mouth heals, you eat soft food

3. About 1 month

   More than half of the swelling goes down

4. Around 6 months

   Most of the swelling has gone down and the jawline is settling

5. Around 1 year

   The remaining swelling goes down a little more

The point at which you can return to daily life and the point at which most of the swelling has gone down are different. The speed of recovery differs from person to person, and the jawline immediately after surgery is not the final shape.

After surgery, you will come to the clinic 2 to 3 times over about 2 weeks. The number of visits and the dates are adjusted according to the surgery and your recovery. Once the day for stitch removal is set, please keep that day if at all possible; the other dates can be adjusted.

So that you do not have to endure recovery alone, the doctor and the nursing team check your swelling, pain, and condition together. The third of our treatment principles is “We see patients more frequently after surgery.”

Precautions after surgery

The key is to keep the wound inside your mouth clean and not to put excessive force on your jaw.

Please keep the following five points in mind.

• It is best to avoid chewing hard or tough food forcefully.
• It is best to avoid forcing your mouth open wide.
• It is best to avoid pressing on or bumping the jaw area.
• After meals, rinse your mouth to keep the wound clean.
• Smoking slows wound healing.

Besides swelling and bruising, bleeding, decreased sensation in the lower lip and chin, left-right asymmetry, unintended fracture of the jawbone, injury to the nerve that moves the corner of the mouth, and jawline sagging can occur. Rarely, the neck can swell and narrow the airway, and there are risks related to general anesthesia.

This is information you need to know before deciding on surgery, so we have written it out in full without shortening it.

This is surgery that cuts away bone. Please make your decision only after fully understanding the items below.

Item by item

For cosmetic purposes, revision surgery is mostly recommended 6 months or more after the operation, but depending on the cause, it is sometimes performed right away.

If you are bothered by the result, we fully understand the wish to fix it as soon as possible. That is why we explain separately the cases in which it should be done quickly and the cases in which it is better to wait.

The timing of revision surgery depends on the cause. In cases like the following, it is better to operate right away without waiting.

• When the bone was fixed because of an unintended fracture or similar, but the fixation is not holding well
• When the bone has not united and is moving
• When there is a wide gap between the bones
• When there is inflammation or infection

Cosmetic revision surgery to refine the shape is mostly recommended 6 months or more after the operation. Before then, swelling remains and the bone and surrounding tissue are still settling into place, so what you see now is not the final shape.

A Word from the Doctor

"Simply reducing the bone is not what matters. How much is appropriately left is also very important."

You can call our main number, 02-541-8500, or apply through Consultation & Booking information.

If you still have questions after reading this, please feel free to ask them at your consultation.

The clinic is located on the 4th floor of Vorati Al Building, 480 Gangnam-daero, Gangnam-gu, Seoul. It is a 1-minute walk from Exit 3 of Sinnonhyeon Station.

At your consultation, please tell us about any previous jaw Botox, procedures, or surgery, the medications you take, whether you smoke, and whether you snore or have sleep apnea. If you have a facial CT scan taken previously, you are welcome to bring it.