Minimally Invasive Mandible Reduction Using Lee’s Rasp & Saw

Mandible reduction is one of the most well-known facial contouring procedures used to reduce the size of the face for Asian patients, and many studies have been conducted. However, these studies have largely included only exposure by the intraoral incision, which can be accompanied by serious emergency situations and complications. Difficulties in mandible reduction can be encountered during the process of maintaining visual sight for the approaching saw. In maintaining the visual field, the patient’s mouth should be widely stretched while the incision and periosteal elevation is extended largely around the entire mandible. This occasionally has been related to serious emergency situations such as airway obstruction caused by edema and massive bleeding. The authors have tried to solve these difficulties with the help of new surgical equipment, which includes a bone dust–collecting rasp with simultaneous suction and irrigation known as Lee’s Rasp & Saw. The “minimally invasive” surgical technique can be used with this new rasp and saw. Rasping is performed through a 4- to 6-mm stab incision like other endoscope-assisted techniques so soft tissue injury is minimized and the operation procedures are simplified. The authors have applied this new surgical method to more than 260 male and female patients, and their experience has been satisfying in terms of decreased complications and reduced operation times. This report describes the external approach only. The authors are evaluating this new method using an intraoral approach as well, and the results are as good as those for the external approach.