Nasal Deformities Associated With Orthognathic Surgery

Abstract

Any surgical procedure undertaken to correct or change facial features will have a resultant effect on nasal aesthetics. Orthognathic surgery is frequently performed to correct congenital and acquired dentofacial anomalies. The resultant changes in the maxillomandibular skeleton have consequences for the overlying soft tissue envelope of the face. This article will review the concepts of nasal analysis and aesthetics. It will then discuss the expected changes to the nasal appearance with orthognathic surgery, primarily LeFort I osteotomies, including a review of the literature that has attempted to quantify and predict these changes. A discussion of surgical techniques to control these changes as well as a discussion of adjunctive rhinoplasty will follow. Surgeons performing these procedures must be aware of the potential changes that can occur to the nasal structure so that they may appropriately plan adjunctive procedures and counsel their patients on both the expected aesthetic outcome and the possible need for subsequent surgeries.

Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

“…Orthognathic surgery has an influence on the overlying soft tissues of the translated osseous maxillomandibular complex. The most common secondary change in the nasolabial region is the enlargement of the nasal base, particularly on the wingspan and the nasal volume [23][24][25]. In our study, however, no cases of nasal wing enlargement were observed.…”

Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

“…Orthognathic surgery has an influence on the overlying soft tissues of the translated osseous maxillomandibular complex. The most common secondary change in the nasolabial region is the enlargement of the nasal base, particularly on the wingspan and the nasal volume [23][24][25]. In our study, however, no cases of nasal wing enlargement were observed.…”

Three-dimensional changes in nose and upper lip volume after orthognathic surgery

“…Altman and Oeltjen 36 have discussed the role of rhinoplastic surgery during maxillomandibular surgery previously. They concluded that changes in nasal morphology after orthognathic surgery are difficult, if not impossible, to predict.…”

Analysis of 3D Soft Tissue Changes After 1- and 2-Jaw Orthognathic Surgery in Mandibular Prognathism Patients

“…Honrado et al 32 stated that maxillary movement during treatment of skeletal Class II malocclusion, Class III malocclusion, open bite deformity significantly increased the inter-alar width regardless of the amount and direction of rotation of the maxilla. According to Altman and Oeltjen, 33 increases in the alar width are the result of the surgical approach to the maxilla rather than the relocation of the maxilla itself. Finally, 1-jaw surgery patients showed slight narrowing of the alar base area, but this amount was clinically insignificant.…”

Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

“…Orthognathic surgery has an influence on the overlying soft tissues of the translated osseous maxillomandibular complex. The most common secondary change in the nasolabial region is the enlargement of the nasal base, particularly on the wingspan and the nasal volume [23][24][25]. In our study, however, no cases of nasal wing enlargement were observed.…”

Three-dimensional changes in nose and upper lip volume after orthognathic surgery

“…Altman and Oeltjen 36 have discussed the role of rhinoplastic surgery during maxillomandibular surgery previously. They concluded that changes in nasal morphology after orthognathic surgery are difficult, if not impossible, to predict.…”

Analysis of 3D Soft Tissue Changes After 1- and 2-Jaw Orthognathic Surgery in Mandibular Prognathism Patients

“…Honrado et al 32 stated that maxillary movement during treatment of skeletal Class II malocclusion, Class III malocclusion, open bite deformity significantly increased the inter-alar width regardless of the amount and direction of rotation of the maxilla. According to Altman and Oeltjen, 33 increases in the alar width are the result of the surgical approach to the maxilla rather than the relocation of the maxilla itself. Finally, 1-jaw surgery patients showed slight narrowing of the alar base area, but this amount was clinically insignificant.…”

Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

“…Orthognathic surgery has an influence on the overlying soft tissues of the translated osseous maxillomandibular complex. The most common secondary change in the nasolabial region is the enlargement of the nasal base, particularly on the wingspan and the nasal volume [23][24][25]. In our study, however, no cases of nasal wing enlargement were observed.…”

Three-dimensional changes in nose and upper lip volume after orthognathic surgery

“…Altman and Oeltjen 36 have discussed the role of rhinoplastic surgery during maxillomandibular surgery previously. They concluded that changes in nasal morphology after orthognathic surgery are difficult, if not impossible, to predict.…”

Analysis of 3D Soft Tissue Changes After 1- and 2-Jaw Orthognathic Surgery in Mandibular Prognathism Patients

“…Honrado et al 32 stated that maxillary movement during treatment of skeletal Class II malocclusion, Class III malocclusion, open bite deformity significantly increased the inter-alar width regardless of the amount and direction of rotation of the maxilla. According to Altman and Oeltjen, 33 increases in the alar width are the result of the surgical approach to the maxilla rather than the relocation of the maxilla itself. Finally, 1-jaw surgery patients showed slight narrowing of the alar base area, but this amount was clinically insignificant.…”