From a Long Face to an Oval Contour: A Dramatic Transformation with Osteotomy and Liposuction While Minimizing Sagging

Today, we will discuss a case in which V-line surgery—an osteotomy procedure that reshapes the lower jawline—was performed together with liposuction.

V-line surgery can involve different surgical techniques depending on the patient’s desired facial contour, and careful adjustments to the angle of the bone cuts are also required.

In the frontal comparison photos, you can see that the U-shaped facial contour has become a sharper, V-shaped contour.

Although liposuction was performed, the buccal fat was not removed, preserving the natural fullness of the cheeks when smiling. Removing buccal fat can make the cheekbones appear more prominent, so it is often left intact when V-line surgery is performed without cheekbone reduction.

This is a full side-view photo. Compared with before surgery, the facial contour appears more compact, with less excess space. The significant change in the angle from the jaw to the chin creates a visual transformation that goes beyond the physical reduction of bone and tissue.

This is an oblique view. The lower jaw, which previously curved downward in a rounded shape, now has a more refined chin with reduced prominence along the body of the mandible. The sharper facial contour also creates the impression of a shorter midface.

Next, we will examine the changes using CT images taken before and after surgery.

There are various techniques for V-line surgery, but WOM CLINIC is the only clinic in Japan capable of performing an osteotomy that creates a long, gently curved bone-cutting line. In this case, the bone was cut in a smooth curve from the chin to the mandibular angles, reshaping with bone a chin that had previously been treated with hyaluronic acid filler and threads.

Chin projection is not simply determined by advancing it a set number of millimeters. The direction of projection can also be adjusted by changing the angle of the osteotomy.

Next, we will show images of the bone that was removed and the fat that was suctioned.

This bone was removed through a continuous osteotomy extending from the mandibular angle to the tip of the chin. The mandibular angle is shown at the top, and the chin tip at the bottom. After the osteotomy, we also assess the contour from the skin side and meticulously refine it by shaving the bone.

Liposuction causes contracture, which can actively improve the swelling, puffiness, and sagging associated with recovery from osteotomy surgery. Although combining liposuction with osteotomy may seem likely to prolong the recovery period, it can actually shorten the recovery time following the osteotomy.

Liposuction is not performed on every osteotomy patient; it is recommended only after determining whether the patient is a suitable candidate. During the consultation, CT imaging is used to assess not only the bones but also the condition of the fat and skin.

We aim to provide the most appropriate advice while carefully listening to your concerns. If you are considering facial contouring, please feel free to schedule a consultation with us.