Jaw Reduction / V-Line Contouring Surgery — what you should know in 2026
A clear guide to mandibular angle reduction and V-line surgery: what bone surgery can and cannot change, how it differs from masseter Botox, and the nerve risk you should understand.
8 min read
What jaw reduction does and who it's for
Jaw reduction surgery narrows the lower face by removing bone from the mandible. The commonest version reduces the mandibular angle, the corner of the jaw near the ear, which is what makes a face look square from the front. V-line surgery is a broader term covering angle reduction combined with narrowing of the chin, usually by a T-shaped osteotomy that removes a central wedge of bone and brings the two halves together.
It is for people whose lower face is wide because of bone, and who want a narrower, more tapered outline. That is a specific complaint with a specific cause, and the operation only works if the cause is right. This is aesthetic bone surgery, not a treatment for jaw function.
It is worth being clear about what it cannot do. It does not tighten skin, it does not remove fat under the chin, and it does not correct a bite problem. If your face is wide because of a heavy masseter muscle or a full lower face rather than bone, cutting bone is the wrong answer.
Surgery versus masseter Botox: getting the diagnosis right
A wide lower face has three common causes, and they need different treatments. Bone, meaning a prominent mandibular angle. Muscle, meaning enlarged masseters, often from clenching or grinding. Soft tissue, meaning fat and skin.
If the width is muscular, botulinum toxin injected into the masseter muscles will slim the face by gradually reducing muscle bulk, with no surgery, no scars and no permanence. It wears off over months and needs repeating, but it is reversible and low risk. Many people who ask about V-line surgery are better served by this, and a good surgeon will say so.
If the width is bony, no injection will change it, and surgery is the only option that will. Most surgeons assess this with palpation and a CT scan, which shows exactly how thick the bone is and, critically, where the inferior alveolar nerve runs inside it. Insist on that assessment before agreeing to bone surgery. A clinic that recommends V-line surgery from a selfie has not made a diagnosis.
How the operation works
The surgery is performed under general anaesthetic, almost always from inside the mouth so there are no external scars. The surgeon exposes the jawbone, and for angle reduction cuts and removes a strip of the mandibular angle, sometimes also shaving the outer cortex of the bone where it flares outward. A long, curved cut that follows the natural jawline generally produces a smoother result than a short cut, which can leave a visible secondary angle.
In a full V-line procedure, the chin is narrowed as well. A central segment of bone is removed and the remaining halves are brought together and fixed with small plates and screws, producing a narrower, more pointed chin. The chin can also be shortened or advanced at the same time if needed.
Operating time depends on how much is done, and most patients stay in hospital at least one night. A drain is often placed. Expect a compression bandage around the face for the first days.
What it costs and what's included
This is maxillofacial bone surgery, and it is priced accordingly: general anaesthetic, an operating theatre, plates and screws, an inpatient stay and imaging all form part of the cost. It is considerably more expensive than injectable treatments, and it should be.
A proper quote should list the CT scan, the surgeon, the anaesthetist, the hospital stay, the fixation hardware, follow-up visits and any revision policy. Ask whether the price covers angle reduction only, or chin surgery as well, since V-line is often quoted as a bundle and the components vary.
Be cautious about extremely low prices for facial bone surgery. The margin for error is small, the consequences of a poor result are difficult to reverse, and the surgeon's experience is the single most important variable you are buying.
Recovery and results
The early recovery is uncomfortable and swollen. Expect significant facial swelling for the first two weeks, difficulty opening your mouth, and a soft or liquid diet for several weeks while the intraoral wounds heal. Most people take two to three weeks off work, longer if they are in public-facing roles, because the swelling is obvious.
Swelling is slow to resolve. A rough guide most surgeons give is that the majority settles by six to eight weeks, but the final contour is not clear for six months or more. Judging your result at one month is judging swelling, not surgery.
The result is permanent, because bone does not grow back. That cuts both ways: a good outcome lasts, and an over-resected or asymmetric outcome is very hard to undo. In older patients, or those with lax skin, removing bony support can allow soft tissue to sag, producing jowling. A careful surgeon will raise this with you if it applies.
Risks and choosing a surgeon
The risk that matters most is nerve injury. The inferior alveolar nerve runs through the lower jaw and supplies sensation to the lower lip and chin; the mental nerve exits near the chin. Both are close to where the surgeon is cutting. Altered sensation or numbness of the lip and chin after surgery is common in the short term and usually recovers over weeks to months, but permanent numbness is a real possibility, particularly in chin surgery.
Other risks include bleeding, infection in the mouth, asymmetry between the two sides, an uneven or palpable step in the bone where the cut ends, and, rarely, fracture of the jaw during or after surgery. Over-resection, taking away more bone than the face can support, produces a gaunt or sagging result that is difficult to correct.
Choose a surgeon who does this operation regularly, works from a CT scan, discusses the nerve openly, and is willing to tell you that you do not need it. Ask to see their own long-term results, not stock photographs. Ask how follow-up works once you are home, since swelling, sensation and shape all evolve over months and you will want someone to review them.
Frequently asked
Is V-line surgery the same as jaw reduction?
They overlap. Jaw reduction usually means reducing the mandibular angle to narrow a square jaw. V-line surgery generally means angle reduction combined with narrowing the chin, often by removing a central wedge of bone, to create a more tapered outline.
Would masseter Botox work instead?
It depends on why your face is wide. If the width comes from enlarged masseter muscles, Botox will slim it gradually with no surgery, though it needs repeating. If the width comes from bone, no injection will change it. A CT scan and examination distinguish the two.
Will I have visible scars?
Usually not. The surgery is almost always performed from inside the mouth, so the incisions are hidden. The trade-off is intraoral wounds, which mean a soft diet and careful mouth hygiene for several weeks.
How long does the swelling last?
Most of it settles over six to eight weeks, but the final contour is not clear for around six months. Expect marked swelling and limited mouth opening for the first two weeks, and plan two to three weeks away from work.
Can the surgery damage a nerve?
Yes, and this is the main risk. The inferior alveolar and mental nerves supply sensation to the lower lip and chin and run close to the surgical field. Temporary numbness is common and usually recovers over weeks to months, but permanent altered sensation is possible, particularly with chin surgery.
Is the result permanent?
Yes. Bone that is removed does not grow back, so a good result lasts. The same is true of a poor one: over-resection or asymmetry is difficult to correct, which is why surgeon experience matters more here than in most aesthetic procedures.
