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Reduction Gonioplasty: Bone Regeneration And Soft-tissue Response
Xi Fu, M.D..
Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.

PURPOSE: Reduction gonioplasty is frequently used to achieve an oval shaped face in Asia. However, the soft-tissue response and bone regeneration of reduction gonioplasty are still unclear. The aim of this study is to evaluate the effects of bone regeneration on facial width and the soft-tissue response of reduction gonioplasty.
Methods: We retrospectively reviewed patients who underwent reduction gonioplasty from 2009 to 2013. A high-speed rotary cutting bur without a water coolant was routinely used in the gonial region, while the mandibular-chin body osteotomy was performed with a reciprocating saw. Forty-nine patients with preoperative, immediate postoperative, and 12-month postoperative frontal cephalograms were included in our study. Mandible and soft tissue profiles were measured on cephalograms.
Results: Bone regeneration in high-speed rotary cutting bur ostectomy region was -0.79±1.76 mm (1cm above Go-Go), -0.75±1.46 mm (Go-Go, bigonial line), -0.77±2.10mm (1cm below Go-Go), while 0.07±1.79 mm (2cm below Go-Go) in ostectomy region performed by reciprocating saw. The soft-tissue response ratios were 76.72 ± 30.70% (Go-Go), 108.8 ± 54.11% (1cm below Go-Go), and 155.9 ± 66.82% (2cm below Go-
Go).
Conclusion: Bone regeneration does not lead to an increase in facial width after reduction gonioplasty with our technique, and the use of a high-speed rotary cutting bur without a water coolant decreases bone regeneration. The soft-tissue response ratio is higher in the anterior mandible and the outcome of reduction gonioplasty is a sharper lower face with a full cheek. Reduction gonioplasty is an effective and predictable lower face reshaping surgery.


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