Can doing cortical osteotomy cause sagging? (As opposed to doing a full jaw reduction) (photo)

There is no reason to do the full thickness bone removal as drawn. That will likely cause a problem. We do this procedure every week by combining partial bone and partial muscle reduction.

If you are looking for a significant slimming of the mandibular angles, then complete removal of the angles of the mandible is best. Cortical osteotomies will provide much less cosmetic changes. Having performed multiple gender affirmation surgeries, I have not seen sagging or Masseter muscle attachment-related problems. Some Masseter muscle reduction can be performed simultaneously. If only a small reduction of the angles is necessary, then cortical reduction may be acceptable.