How do intraoral (inside the mouth) and extraoral (outside the mouth) incisions used in maxillofacial surgery compare in terms of scar formation and accessibility?

Almost all modern orthognathic surgery operations are performed entirely through intraoral incisions made inside the mouth to ensure that no visible scars remain on the patient’s face; this approach is aesthetically flawless but requires high technical skill as it restricts the surgeon’s field of vision. Extraoral incisions are only made under the chin or in front of the ear in very extreme jaw fractures, advanced tumor resections, or very rare anatomical variations where the lower jaw corner cannot be accessed through the mouth. Although extraoral incisions provide the surgeon with an excellent field of vision and ease of manipulation, they are never considered the first option in orthognathic surgery due to the risk of facial paralysis (facial nerve damage) and the disadvantage of leaving permanent scar tissue on the facial skin.