Our Treatment Principles

Our criteria for recommending surgery: And the days we did not recommend it.

We first lay out the criteria on which we recommend orthognathic (double jaw) and facial contouring surgery, then share, as they happened, three consultations in which we did not recommend surgery because of those criteria. Names are not used.

When We Recommend Surgery

the benefits must always outweigh the risks.

01
Orthognathic surgery is an appropriate and effective treatment for skeletal malocclusion, and we consider it first when a patient has skeletal malocclusion.
02
However, the "gain" of improved function and aesthetics from surgery must always outweigh the "cost" that surgery requires.
03
Orthognathic surgery performed purely for aesthetic reasons is considered only when the patient's expectations or goals can be achieved through orthognathic surgery alone.
04
Contouring surgery is performed for aesthetic improvement rather than function, so we always first determine exactly what the patient expects and whether contouring surgery can meet those expectations.
05
The goal and direction the patient hopes to achieve through surgery must match the surgeon's goal and direction.

"I try to be straightforward: I explain why something can be done and why something can't."
— Dr. Sang-Hoon Lee

Consultation Records

Three consultations in which we did not recommend surgery

These are actual consultation records compiled by the director. The conclusion that begins with "Surgery itself can be considered, but" is how this clinic works.

What they wanted · Square jaw surgery

For those who feel their square jaw bone still looks prominent even after genioplasty (chin surgery)

Patient K (late 20s)

On the panoramic X-ray, the square jaw (mandibular angle) area was not severely developed. Reshaping the bone may give some sense of improvement, but even with surgery in the current condition, it is difficult to expect a dramatic change.
Because the square jaw sat low on the face, the amount of bone that could be removed by surgery was limited. We explained that the degree of improvement surgery can offer and the burden of surgery need to be considered together.
We explained that a relatively prominent upper jaw, rather than a square jaw, may be affecting the shape of the face, and that if improvement in that area is desired, it must be addressed through the upper jaw rather than lower jaw surgery alone.

Consultation conclusion — Surgery itself can be considered, but because the change we can expect from the current skeletal shape is limited, we did not actively recommend square jaw surgery.

Alternative · Guided the patient to decide carefully, considering the direction of improvement they want and the scope of surgery

What the patient wanted · Cheekbone reduction · Improving facial balance

A patient who consulted about cheekbone reduction to achieve a smaller, slimmer face

Patient L (mid-20s)

The cheekbones were not markedly prominent, and the overall contour was good. In terms of the face's width-to-length ratio, the face was fairly long and narrow, so it was not a case in which a lot of bone could be reduced.
Even with cheekbone reduction, the width at the temple area remains, so it is difficult to significantly reduce the overall width of the face. The change surgery could achieve was limited, so there was a possibility of a gap between expectations and actual results.
Even with orthognathic surgery, it is hard to expect a dramatic improvement in face shape, and the benefit of surgery was not large, so it was difficult to recommend.

Consultation conclusion — Because the cheekbones were not very prominent and the change achievable through skeletal surgery was limited given the facial proportions, we did not actively recommend cheekbone reduction or orthognathic (double jaw) surgery.

Alternative · Considering that the face has fatty tissue, we suggested non-surgical options such as contouring injections and Shrink as alternatives

What they wanted · Orthognathic surgery · Correction of facial asymmetry

A patient who visited to find out why their jaw had appeared to protrude for about a year

Ms. J (mid-20s)

In terms of measurements, the jaw position fell within the average range for Koreans. Slight left-right facial asymmetry was observed, but not to a degree requiring surgical correction.
The current asymmetry may look more pronounced because of a combination of factors, such as differences in eye and ear height, a tilted nose, and differences in facial volume. Not all of these differences can be corrected by surgery, and it was necessary to distinguish between the asymmetry the patient perceives and the actual skeletal condition.
In the actual diagnosis, the jaw was not severely protruding, and even with surgery it might have been difficult to fully resolve the asymmetry the patient perceived.

Consultation conclusion — Although there was slight facial asymmetry and a sense that the jaw looked prominent, the actual skeletal condition did not require orthognathic surgery, so we did not recommend surgery.

Alternative · Tooth alignment looked good on CT; if a more precise bite and dentition evaluation is needed, we advised having it checked at an orthodontic clinic

Why we do it this way

It is inefficient for a single director to oversee the entire process. Even so, this is how we do it.

Having one surgeon oversee the entire process of a patient's surgery is quite inefficient. However, when one surgeon is involved in every step, it brings a great advantage for the patient.

Because patients take part in every diagnostic step and decision made before surgery, they come to place complete trust in their surgeon. The surgeon, in turn, has addressed any excessive or unrealistic requests in advance, so the treatment plan is built to reach a result that both patient and surgeon have fully agreed upon.
We explain plainly why some things are possible and why others are not. In reviews, we often see comments like "I appreciated that they told me clearly what could and could not be done."
There are times when Dr. Lee is still caring for surgery patients late on the day of surgery, and family members tell us it puts their minds at ease.
We tell you as much as we can in advance about what to expect during this process, and we do our best to stay by your side at the points where it may be hardest for you.

This content was reviewed by board-certified oral & maxillofacial surgeon Dr. Sang-Hoon Lee, Directorfor medical accuracy · Last reviewed 2026.10.21

CONSULTATION

First, let's look at whether your face actually needs surgery.

If we determine during your consultation that surgery isn't necessary, we will tell you so. Listen thoroughly, see it in 3D, and take your time to decide.

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