Mandibular retrusion six-piece contouring by combined anterior subapical setback, BSSO advancement, and two-step genioplasty

The 6- piece mandibular osteotomies was described in 1988 by Obwegeser H.L.; mobilizations interested 4 segments and the continuity between the left and right bodies was preserved. This piece of work aims to present a single surgical session for treating an adult with severe developmental deficiency of the mandible. The vertical height and projection of the patient middle third of the face and the SNA angle were within normal ranges contrasting to the 65° SNB. The 5-h procedures involved, in consequence, an incisor-canine subapical setback, an extended BSSO advancement and a double-stepped augmentation genioplasty. The lower third of the face was advanced by 25 mm. Combining mandibular osteotomies may safely save time and expenses. [Display omitted] •A 25 mm projection of the lower 1/3 of the face is achievable in one session.•Mandibular front setback + BSSO + chin advancement treat stark-retrusion.•When mandibular arch is not too narrow, a midline osteotomy is not required.