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Clockwise Rotation of the Occlusal Plane for Aesthetic Purposes by Double Jaw Surgery without Orthodontic Treatment

Lee, Tae Sung M.D.; Park, Sanghoon M.D., Ph.D.

Plastic and Reconstructive Surgery: December 2019 - Volume 144 - Issue 6 - p 1010e-1013e
doi: 10.1097/PRS.0000000000006248
Cosmetic: Ideas and Innovations

Summary: The occlusal plane angle is an important factor in lateral facial aesthetics. Low occlusal plane facial profiles appear planar and long-faced, whereas high occlusal plane facial profiles are considered more attractive, especially in Asian regions. Clockwise rotation of the occlusal plane for truly aesthetic purposes can be accomplished with double jaw surgery, without need for orthodontic treatments. Patients with normal occlusion who desired to improve their lateral facial aesthetics were included in this study. A conventional Le Fort I osteotomy was followed by a sagittal split ramus osteotomy under general anesthesia. The movement of the maxillomandibular complex was determined in accord with a preoperative analysis. From 2015 to 2017, 43 patients with normal occlusion underwent double jaw surgery without orthodontic treatment. Whereas all patients were subjectively satisfied with the surgery, two underwent orthodontic treatment to correct mild occlusal discrepancies noticed after surgery. There were no delayed occlusal problems or relapses reported during the study. For patients who desired to improve their lateral facial aesthetics but had normal occlusion, orthognathic surgery without orthodontic treatment can be effective. Clockwise rotation of the occlusal plane by double jaw surgery without orthodontic treatment resulted in satisfactory aesthetic outcomes with stable and reliable long-term results.


Seoul, Republic of Korea

From the Center for Maxillofacial Surgery, ID Hospital

Received for publication November 22, 2018; accepted March 28, 2019.

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Disclosure:The authors have no financial interest in any of the products or devices mentioned in this article.

Sanghoon Park, M.D., Ph.D., Center for Maxillofacial Surgery, ID Hospital, Dosan-daero 142, Gangnam-gu, Seoul 06039, Republic of Korea,

Copyright © 2019 by the American Society of Plastic Surgeons