V-Line Surgery

First, we will show you the basic information.

Because this is surgery on the bone, you may have many worries. Below we explain in order the method, how it relates to square jaw surgery and chin surgery, recovery, side effects, and symptoms to have checked promptly.

V-Line Surgery is the name for planning and performing square jaw surgery and chin surgery together.

In a word, it is surgery in which the corner of the jaw and the chin are planned together at once rather than looked at separately.

Square jaw surgery works on the corner of the jaw below the ear, and chin surgery works on the very front of the jaw. If the two surgeries are planned separately, the balance of the jawline can be thrown off along the side of the jaw between the corner and the chin, so the method of looking at and planning the entire jawline at once, from the square jaw to the chin, is called V-Line Surgery.

At our clinic, in the square jaw stage the basic method is cutting in a long curve from the corner of the jaw to the side of the jaw toward the front, with the outer bone plate (lateral cortex) added as a supplement if needed, and in the chin surgery stage we mainly use a T-shaped osteotomy, which allows the width, length, and front-back position to be adjusted together, with fixation by a metal plate or fixation pins.

The chin stage of V-Line Surgery is surgery that cuts the chin bone. It is a different surgery from surgery that places an implant in the chin.

A Word from the Doctor

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

The face is not flat

Facial contouring surgery must consider not only the size seen from the front but also the cross-section of the face, the volume of the sides, and dimension. We plan with the thought that, for the patient, it is a one-time-only chance, aiming for a natural facial line matched to ideal proportions and angles. Before surgery, the positions of the bones and nerves are checked on X-ray, and the surgical method is decided to fit each person's face.

It is done when not only the corner of the jaw but also the side of the jaw and the chin are wide, so the whole lower face looks square.

As you read the list below, picture your jawline in the mirror.

• When, from the front, the jaw looks widely flared from below the ear to the jaw beside the corner of the mouth
• When, even if the corner of the jaw is reduced, the chin is wide and angular and the jawline seems likely to look dull
• When you previously had surgery on the corner of the jaw only, and the area where it joins the jawline toward the front looks stepped

We do not recommend surgery right away just because something applies. The first of our treatment principles is "We never recommend excessive surgery." If the corner of the jaw alone or the chin alone is enough, we will tell you so.

A Word from the Doctor

"It is better not to think of doing every contouring surgery to make the face smaller. Your face may become smaller, but it may not become prettier."

If the jaw looks wide because of muscle, soft tissue, or sagging rather than bone, V-Line Surgery may not produce the change you expect.

This is why we first confirm the cause before deciding on surgery.

When the width is caused by muscle or soft tissue

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

You may want to check in front of a mirror. The exact cause is determined at the examination.

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

Which is larger, the bone, the muscle, or the soft tissue, is determined by an examination and a CT scan (a test that images the bone in three dimensions). Injections that reduce muscle are explained in Botox treatment information.

A Word from the Doctor

"Bone surgery is not the only kind of contouring."

When the jawline has started to sag in your 40s and 50s

If the jawline has become blurred because of sagging, reducing the bone can make the sagging more noticeable, so surgery to lift the sagging is considered first.

If a square jaw that has bothered you for years is now starting to appear together with sagging, please read the information below first.

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.

When the teeth do not meet properly

If the lower teeth sit far behind or far in front of the upper teeth, V-Line Surgery alone may not be enough.

V-Line Surgery reduces only the outer contour of the jawbone and does not change how the upper and lower teeth fit together (occlusion). If the cause is the size or position of the whole lower jaw and a malocclusion (a condition in which the upper and lower teeth do not close properly) is also present, orthodontic treatment and corrective jaw surgery (such as double jaw surgery) must be considered together.

The usual method is to make incisions in the gum outside the lower molars and the gum inside the lower lip, then shape the bone from the jaw angle to the chin and close the incisions with sutures (stitches).

Incisions are made only inside the mouth. Dissolving sutures are used, and the stitches are removed inside the mouth after 2 weeks. Because the surgery is performed through the mouth, no scar is left on the outside of the face. In exchange, the bone is cut along a long line through a narrow incision inside the mouth, so it is important to confirm the position of the nerve in advance at the planning stage.

At our clinic, the basic method is to cut in one long curve from the jaw angle to the front of the side of the jaw, and if the width seen from the front needs to be reduced further, a plate of the outer bone (outer cortical bone) is added as a supplementary step. For the chin, we mainly use a T-shaped osteotomy, which allows width, length, and front-to-back position to be adjusted together, and the repositioned bone is fixed with small metal plates or fixation pins.

Surgery is performed under general anesthesia, and the operating time for square jaw surgery and chin surgery combined is roughly 2 to 3 hours. You stay in the hospital for one day after surgery.

V-Line Surgery combines square jaw surgery with surgery that cuts the chin bone, so it is performed under general anesthesia. It is a different operation from chin implant insertion, which is done under sedation or local anesthesia.

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 may feel vague the first time, we have laid it out step by step.

1. Consultation and planning

Using face photos and CT, we look at the shape of the jaw angle, the side of the jaw, and the chin, left-right differences, the route the nerve takes, and the position of the tooth roots. Please tell us about all medications you take and any conditions you have. Before surgery, tests for general anesthesia are performed. Even things that seem minor are fine to mention.

2. Anesthesia

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

3. An incision is made inside the mouth and the bone is cut from the jaw angle to the side of the jaw

An incision is made in the gum outside the lower molars, and the bone is cut in a long curve along the planned line from the jaw angle to the front of the side of the jaw. If the width seen from the front needs to be reduced further, a thin layer of the outer bone (outer cortical bone) on the side of the jaw is additionally removed.

4. The chin bone is shaped and fixed

An incision is made in the gum inside the lower lip, and the place where the nerve for chin sensation exits is identified and protected. If the chin is wide, a middle piece is removed, the bone is cut in a T shape, the two sides are brought together, and they are fixed with small metal plates or fixation pins. This step is surgery that cuts the chin bone, and no implant is inserted. The border is smoothed so that the line cut on the side of the jaw and the line cut at the chin connect smoothly.

5. Bleeding is stopped, the incisions are closed, and compression is applied

After the bleeding is stopped and the detached chin muscle is reattached in its original position, the incisions are closed with dissolving sutures. To reduce swelling and bleeding, a compression band that wraps the face and chin is worn for about 1 week. The stitches for both the square jaw step and the chin step are removed inside the mouth after 2 weeks. You stay in the hospital for one day after surgery.

Generally, you can return to some degree of daily life 1 to 2 weeks after surgery. Swelling lasts longer than this: much of the major swelling goes down during the first month, and the remaining swelling goes down slowly over several months. Sensation in the lower lip may take even longer to return.

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.

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 visit the clinic 2–3 times over about 2 weeks. The number and dates of visits are adjusted according to the surgery and your recovery. Dissolving sutures are used for closure, and the stitches are removed inside the mouth after 2 weeks. Please keep the stitch removal day if 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 points are keeping the wounds inside the mouth clean and not putting excessive force on the jaw and chin.

We realize it may be inconvenient, but everything below is meant to help the wound heal well.

• It is best to avoid chewing hard or tough food forcefully, or biting food off with the front teeth.
• Be careful not to open your mouth wide or bite down hard for about 1 month.
• It is best to avoid pressing on or bumping the jaw and chin.
• It is best to avoid turning your lower lip inside out to look at the wound.
• After meals, rinse your mouth to keep the wound clean.
• Smoking slows wound healing and bone union.

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 the consultation, please tell us about any jaw Botox, chin filler, implants, or surgery you have had before, whether you have had orthodontic treatment, the medications you take, whether you smoke, and whether you snore or have sleep apnea. If you have a facial CT taken previously, you are welcome to bring it.