J Korean Assoc Oral Maxillofac Surg 2017; 43(5): 318~323
Inferior alveolar nerve cutting; legal liability versus desired patient outcomes
Soung Min Kim1,2, Jong Ho Lee2
1Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana,
2Department of Oral and Maxillofacial Surgery, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
Jong Ho Lee
Department of Oral and Maxillofacial Surgery, Dental Research Institute, Clinical Trial Center and Oral Cancer Center, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
TEL: +82-2-2072-2630 FAX: +82-2-766-4948
E-mail: leejongh@snu.ac.kr
ORCID: http://orcid.org/0000-0001-5808-6327
Received May 20, 2017; Accepted June 25, 2017.; Published online October 31, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be.
Materials and Methods: We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient’s perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University.
Results: Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation.
Conclusion: This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon’s position with respect to legal liability.
Keywords: Facial contouring surgery, Legal liability, Less-than-perfect outcome of beauty, Unsolicited patient complaints, Medical malpractice


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31 December 2017
Vol. 43
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