Several techniques for mandibular angle plasty have been reported since Back first described the details of aesthetic mandibular angle plasty in 1989. However,patient selection and operative application are the keys to obtaining a satisfactory result.I personally first select the patients according to their gonial angle measurement and pogonion position. Then, depending on each patient's condition, one of the following operative methods is indicated:multistaged curved osteotomy (MCO), angle splitting osteotomy (ASO),or osteotomy of the lateral cortex (OLC).MCO is a good choice for those who have a smaller than average gonial angle with or without a protruding pogonion, whereas ASO is adequate for those with a larger than average gonial angle with or without protruding pogonion, OLC provides good results in patients with a larger than average gonial angle with a protruding pogonion.Excellent results will be obtained by precise preoperative assessment and adequate application of procedure.Care must be taken not to disturb the aesthetic harmony of the mandibular shape with over resection.
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