Faceline Dr. Jinsu Lee's Plastic Surgery Essay- "Please resect all the bone below the nerve line!"

Faceline Dr. Jinsu Lee's 

Plastic Surgery Essay

"Please resect all the bone below the nerve line!"

Facial contouring surgery is a surgery to change facial shape by polishing facial bones. To change the face shape by polishing the face bones,

Soft tissues (skin, fat, muscle, etc.) outside the bones must react to the facial bones. In order to change the face, the soft tissues must react. Conversely, the maximum amount of soft tissues reaction is the maximum effect of the facial contouring surgery.

At first glance, it seems that if we resect your bones as much as possible, your face shape would change to the maximum. However, the result will not come out in that way. If the bone is resected more than soft tissues reaction, the shape of the trimmed bone will not be reflected, and the remaining soft tissues will become saggy form.

When I consult in outpatient clinic, I often hear the question,

"Is my nervousness high or low?"

In the lower jaw (mandible), there is a tooth called nerve alveolaris inferior and

the nerve that is responsible for the sensation of the lower lip passes. When the nerve is taken by the x-ray of the face bone, it shows that the nerve passes through the middle of or slightly down the jaw bone. So, it tends to think that if the nerve line is high, we can resect a lot of bones to make it much slimmer, and when the nerve line is low, the bones will be resected so much less.

I often hear the same demand such as "I want to be much slimmer, so please remove all the bones located below the nerve line!" It is because people think removing all the bones below the nerve line makes the jaw slimmer. 

However, if you actually cut out all the bones underneath the nerves, the soft tissue does not reflect all the missing space. Especially, the middle part of the chin line (the middle part between the front chin and angle) is the least responsive. If you cut a lot underneath the nerve line, the relatively well-reacted parts of each part rise up a lot, and the shape of the line can be like so called dog jaw (similar to the shape of dog's jaw which does not have any angles). And also, Middle jaw line does not rise up enough so its shape seems saggy. This shape is similar to the jaw line of an elderly person whose jaw line is elongated because of his age.

It is not important to resect a lot of bones, but the bones have to be resected in to the extent that the soft tissues react in order to make a beautiful jaw line. In addition, controlling the details such as resecting a little at the well-reacted site, resecting more at the less reactive site, and the amount, direction and location of resection is quite crucial.

There was a drama about the baptism of the hair designer I had seen before. There was a saying in the line from the drama, "When I cut my hair I think about how much I will leave without thinking about how much I will cut." I also think about the bones that will be remained not about the size of the bone to be resected when I resect the jaw bone.

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