Download PDF
Facial Plast Surg 2017; 33(05): 519-525
DOI: 10.1055/s-0037-1606334
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Facial Soft Tissue Effects of Orthognathic Surgery

Daljit S. Gill
1   Maxillofacial and Dental Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
2   Orthodontics, UCLH Eastman Dental Hospital, London, United Kingdom
,
Timothy Lloyd
3   Oral and Maxillofacial Surgery, UCLH Eastman Dental Hospital, London, United Kingdom
,
Charles East
4   Craniofacial Unit, UCLH NHS Foundation Trust, London, United Kingdom
,
Farhad B. Naini
5   Orthodontics/Maxillofacial, St George's Hospital and Medical School, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
29 September 2017 (online)

Also available at
   Permissions and Reprints

Abstract

Orthognathic surgery is undertaken to correct anteroposterior, vertical, and transverse anomalies of the maxilla and mandible. Surgery has significant effects on the overlying soft tissue envelope. Some of these effects are beneficial while others may be detrimental to facial aesthetics. This review aims to update the reader on what soft tissue changes occur following orthognathic surgery to the mandible and maxilla. It is important to anticipate the detrimental effects of orthognathic surgery as this will allow the patient to be warned about them before treatment and in some cases, adjunctive procedures may be planned to limit the unwanted changes.

Keywords

orthognathic surgery - maxillary advancement - maxillary impaction - mandibular advancement - mandibular setback - genioplasty - soft tissues
 

  • Recommended Reading

  • Naini FB, Gill DS. Orthognathic Surgery: Principles, Planning and Practice. New York, NY: John Wiley & Sons Ltd; 2017
    Search in Google Scholar

    • References

    • 1 Naini FB, Cobourne MT, McDonald F, Wertheim D. The aesthetic impact of upper lip inclination in orthodontics and orthognathic surgery. Eur J Orthod 2015; 37 (01) 81-86
      CrossrefPubMedSearch in Google Scholar
    • 2 Nooreyazdan M, Trotman CA, Faraway JJ. Modeling facial movement: II. A dynamic analysis of differences caused by orthognathic surgery. J Oral Maxillofac Surg 2004; 62 (11) 1380-1386
      CrossrefPubMedSearch in Google Scholar
    • 3 Kaipatur NR, Flores-Mir C. Accuracy of computer programs in predicting orthognathic surgery soft tissue response. J Oral Maxillofac Surg 2009; 67 (04) 751-759
      CrossrefPubMedSearch in Google Scholar
    • 4 Mobarak KA, Espeland L, Krogstad O, Lyberg T. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome. Am J Orthod Dentofacial Orthop 2001; 119 (04) 353-367
      CrossrefPubMedSearch in Google Scholar
    • 5 Zoumalan RA, Larrabee Jr WF. Anatomic considerations in the aging face. Facial Plast Surg 2011; 27 (01) 16-22
      Thieme ConnectPubMedSearch in Google Scholar
    • 6 Soncul M, Bamber MA. Evaluation of facial soft tissue changes with optical surface scan after surgical correction of Class III deformities. J Oral Maxillofac Surg 2004; 62 (11) 1331-1340
      CrossrefPubMedSearch in Google Scholar
    • 7 Kau CH, Cronin AJ, Richmond S. A three-dimensional evaluation of postoperative swelling following orthognathic surgery at 6 months. Plast Reconstr Surg 2007; 119 (07) 2192-2199
      CrossrefPubMedSearch in Google Scholar
    • 8 Day CJ, Robert T. Three-dimensional assessment of the facial soft tissue changes that occur postoperatively in orthognathic patients. World J Orthod 2006; 7 (01) 15-26
      PubMedSearch in Google Scholar
    • 9 van der Vlis M, Dentino KM, Vervloet B, Padwa BL. Postoperative swelling after orthognathic surgery: a prospective volumetric analysis. J Oral Maxillofac Surg 2014; 72 (11) 2241-2247
      CrossrefPubMedSearch in Google Scholar
    • 10 Holty JE, Guilleminault C. Maxillomandibular advancement for the treatment of obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med Rev 2010; 14 (05) 287-297
      CrossrefPubMedSearch in Google Scholar
    • 11 Schendel SA, Carlotti Jr AE. Nasal considerations in orthognathic surgery. Am J Orthod Dentofacial Orthop 1991; 100 (03) 197-208
      CrossrefPubMedSearch in Google Scholar
    • 12 Altman JI, Oeltjen JC. Nasal deformities associated with orthognathic surgery: analysis, prevention, and correction. J Craniofac Surg 2007; 18 (04) 734-739
      CrossrefPubMedSearch in Google Scholar
    • 13 O'Ryan F, Schendel Jr SA. Nasolabial esthetics and maxillary surgery. In: Bell WH. , ed. Modern Practice in Orthognathic and Reconstructive Surgery. St. Louis, MO: W.B. Saunders; 1992
      Search in Google Scholar
    • 14 Millard Jr DR. The alar cinch in the flat, flaring nose. Plast Reconstr Surg 1980; 65 (05) 669-672
      CrossrefPubMedSearch in Google Scholar
    • 15 Howley C, Ali N, Lee R, Cox S. Use of the alar base cinch suture in Le Fort I osteotomy: is it effective?. Br J Oral Maxillofac Surg 2011; 49 (02) 127-130
      CrossrefPubMedSearch in Google Scholar
    • 16 Liu X, Zhu S, Hu J. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117 (01) 37-44
      CrossrefPubMedSearch in Google Scholar
    • 17 Ritto FG, Medeiros PJ, de Moraes M, Ribeiro DPB. Comparative analysis of two different alar base sutures after Le Fort I osteotomy: randomized double-blind controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111 (02) 181-189
      CrossrefPubMedSearch in Google Scholar
    • 18 Khamashta-Ledezma L, Naini FB. Systematic review of changes in maxillary incisor exposure and upper lip position with Le Fort I type osteotomies with or without cinch sutures and/or VY closures. Int J Oral Maxillofac Surg 2014; 43 (01) 46-61
      CrossrefPubMedSearch in Google Scholar
    • 19 McCollum AGH, Dancaster JT, Evans WG, Becker PJ. Sagittal soft-tissue changes related to the surgical corrections of maxillary-deficient class III malocclusions. Semin Orthod 2009; 15 (03) 172-184
      CrossrefPubMedSearch in Google Scholar
    • 20 Conley RS, Boyd SB. Facial soft tissue changes following maxillomandibular advancement for treatment of obstructive sleep apnea. J Oral Maxillofac Surg 2007; 65 (07) 1332-1340
      CrossrefPubMedSearch in Google Scholar
    • 21 Lin SS, Kerr WJ. Soft and hard tissue changes in Class III patients treated by bimaxillary surgery. Eur J Orthod 1998; 20 (01) 25-33
      CrossrefPubMedSearch in Google Scholar
    • 22 Jensen AC, Sinclair PM, Wolford LM. Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop 1992; 101 (03) 266-275
      CrossrefPubMedSearch in Google Scholar
    • 23 Betts NJ, Vig KW, Vig P, Spalding P, Fonseca RJ. Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla. Int J Adult Orthodon Orthognath Surg 1993; 8 (01) 7-23
      PubMedSearch in Google Scholar
    • 24 Dann III JJ, Fonseca RJ, Bell WH. Soft tissue changes associated with total maxillary advancement: a preliminary study. J Oral Surg 1976; 34 (01) 19-23
      PubMedSearch in Google Scholar
    • 25 Mommaerts MY, Lippens F, Abeloos JV, Neyt LF. Nasal profile changes after maxillary impaction and advancement surgery. J Oral Maxillofac Surg 2000; 58 (05) 470-475 , discussion 475–476
      CrossrefPubMedSearch in Google Scholar
    • 26 San Miguel Moragas J, Van Cauteren W, Mommaerts MY. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part I: maxillary repositioning osteotomy. J Craniomaxillofac Surg 2014; 42 (07) 1341-1351
      CrossrefPubMedSearch in Google Scholar
    • 27 Kim YI, Park SB, Son WS, Hwang DS. Midfacial soft-tissue changes after advancement of maxilla with Le Fort I osteotomy and mandibular setback surgery: comparison of conventional and high Le Fort I osteotomies by superimposition of cone-beam computed tomography volumes. J Oral Maxillofac Surg 2011; 69 (06) e225-e233
      CrossrefPubMedSearch in Google Scholar
    • 28 Soydan SS, Bayram B, Sar C, Uckan S. Change in inferior sclera exposure following Le Fort I osteotomy in patients with midfacial retrognathia. J Oral Maxillofac Surg 2014; 72 (01) 166.e1-166.e5
      CrossrefPubMedSearch in Google Scholar
    • 29 Joss CU, Joss-Vassalli IM, Kiliaridis S, Kuijpers-Jagtman AM. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular advancement: a systematic review. J Oral Maxillofac Surg 2010; 68 (06) 1260-1269
      CrossrefPubMedSearch in Google Scholar
    • 30 Behrents RG. Growth in the aging craniofacial skeleton. In: McNamara JA. , ed. Monograph 17, Craniofacial Growth Series. Ann Arbor, MI: University of Michigan; 1985
      Search in Google Scholar
    • 31 Maal TJJ, de Koning MJJ, Plooij JM. , et al. One year postoperative hard and soft tissue volumetric changes after a BSSO mandibular advancement. Int J Oral Maxillofac Surg 2012; 41 (09) 1137-1145
      CrossrefPubMedSearch in Google Scholar
    • 32 Joss CU, Joss-Vassalli IM, Bergé SJ, Kuijpers-Jagtman AM. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: a systematic review. J Oral Maxillofac Surg 2010; 68 (11) 2792-2801
      CrossrefPubMedSearch in Google Scholar
    • 33 McDonnell JP, McNeill RW, West RA. Advancement genioplasty: a retrospective cephalometric analysis of osseous and soft tissue changes. J Oral Surg 1977; 35 (08) 640-647
      PubMedSearch in Google Scholar
    • 34 Park HS, Ellis III E, Fonseca RJ, Reynolds ST, Mayo KH. A retrospective study of advancement genioplasty. Oral Surg Oral Med Oral Pathol 1989; 67 (05) 481-489
      CrossrefPubMedSearch in Google Scholar
    • 35 Davis WH, Davis CL, Daly BW, Taylor III C. Long-term bony and soft tissue stability following advancement genioplasty. J Oral Maxillofac Surg 1988; 46 (09) 731-735
      CrossrefPubMedSearch in Google Scholar
    • 36 Nishioka GJ, Mason M, Van Sickels JE. Neurosensory disturbance associated with the anterior mandibular horizontal osteotomy. J Oral Maxillofac Surg 1988; 46 (02) 107-110
      CrossrefPubMedSearch in Google Scholar
    • 37 Polido WD, de Clairefont Regis L, Bell WH. Bone resorption, stability, and soft-tissue changes following large chin advancements. J Oral Maxillofac Surg 1991; 49 (03) 251-256
      CrossrefPubMedSearch in Google Scholar
    • 38 Talebzadeh N, Pogrel MA. Long-term hard and soft tissue relapse rate after genioplasty. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91 (02) 153-156
      CrossrefPubMedSearch in Google Scholar
    • 39 Reddy PS, Kashyap B, Hallur N, Sikkerimath BC. Advancement genioplasty--cephalometric analysis of osseous and soft tissue changes. J Maxillofac Oral Surg 2011; 10 (04) 288-295
      CrossrefPubMedSearch in Google Scholar
    • 40 Soydan SS, Cubuk S, Pektas ZO, Uckan S. The extent of chin ptosis and lower incisor exposure changes following the osseous genioplasties. J Craniofac Surg 2013; 24 (05) e445-e458
      CrossrefPubMedSearch in Google Scholar
    • 41 Park JY, Kim MJ, Hwang SJ. Soft tissue profile changes after setback genioplasty in orthognathic surgery patients. J Craniomaxillofac Surg 2013; 41 (07) 657-664
      CrossrefPubMedSearch in Google Scholar