Natural Head Postures of Patients With Facial Asymmetry in Frontal View Are Corrected After Orthognathic Surgeries

Kim, Ji-Youn; Kang, Moon-Ho; You, Jun-Young; Jee, Hyeon-Gun; Yi, Jin Wook; Kim, Byoung‐Ho

doi:10.1016/j.joms.2015.07.001

Cited by 11 publications

(8 citation statements)

References 38 publications

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“…Delimiting the boundary for which the asymmetry turns from physiological to pathological is not always an easy task. When the level of asymmetry becomes more severe, the overall aesthetics of the face can be compromised 7,8 .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis

Pozzo

Gibelli

Beltramini

et al. 2020

Journal of Craniofacial Surgery

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In modern orthognathic surgery, the functional results cannot disregard a good aesthetic outcome. In this study, a stereophotogrammetric longitudinal analysis of the symmetry of facial thirds was performed in 18 patients affected by Class III skeletal malocclusion, with clinical asymmetry, treated with a bimaxillary osteotomy. Their 3D facial images were acquired in the preoperative phase and 6, 12 and 24 months after surgery, and compared to those obtained in a control group of 23 subjects with Class I skeletal occlusion, without clinical asymmetry and no history of traumas or alterations at the maxillo-facial area. Images of the hemi-faces of the subjects were divided into thirds (upper, middle, lower), mirrored and superimposed to their contralateral ones; soft-tissue facial symmetry was obtained as the Root Mean Square Distance (RMSD) between the hemi-faces in the three thirds. In patients, no significant differences in facial symmetry (RMSD) were found among the study time points (ANOVA, p > 0.05); the lower facial third was more asymmetric than the upper one (Tukey's HSD p < 0.05). Patients were significantly more asymmetric than the control subjects (Student's t, p < 0.05). In conclusion, patients with Class III malocclusion exhibited a higher level of facial asymmetry than control subjects; their asymmetry did not change significantly in the different phases of the surgical and orthodontic treatment and throughout a 24month follow-up. In skeletal Class III patients, bimaxillary osteotomy did not modify the level of asymmetry in any facial third.

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Section: Introductionmentioning

confidence: 99%

The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis

Pozzo

Gibelli

Beltramini

et al. 2020

Journal of Craniofacial Surgery

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“…The amount of asymmetry of the face can vary among subjects, ranging from unperceived or subclinical cases to evident and clear ones. In those cases, aesthetics, appearance and functionality of the orofacial district can be severely affected, leading to discomfort and dissatisfaction of the patients for their own facial appearance (Kim et al 2015;Thiesen et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Facial thirds–based evaluation of facial asymmetry using stereophotogrammetric devices: Application to facial palsy subjects

Codari

Pucciarelli

Stangoni

et al. 2017

Journal of Cranio-Maxillofacial Surgery

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Many conditions can compromise facial symmetry, resulting in an impairment of the affected person from both esthetic and functional points of view. For these reasons, a detailed, focused, and objective evaluation of facial asymmetry is needed, both for surgical planning and for treatment evaluation. In this study, we present a new quantitative method to assess symmetry in different facial thirds, objectively defined on the territories of distribution of trigeminal branches. A total of 70 subjects (40 healthy controls and 30 patients with unilateral facial palsy) participated. A stereophotogrammetric system and the level of asymmetry of the subjects' hemi-facial thirds was evaluated, comparing the root mean square of the distances (RMSD) between their original and mirrored facial surfaces. Results show a high average reproducibility of area selection (98.8%) and significant differences in RMSD values between controls and patients (p = 0.000) for all of the facial thirds. No significant differences were found on different thirds among controls (p > 0.05), whereas significant differences were found for the upper, middle, and lower thirds of patients (p = 0.000). The presented method provides an accurate, reproducible, and local facial symmetry analysis that can be used for different conditions, especially when only part of the face is asymmetric.

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“…24,31 Nevertheless, most patients' head is habitually in the NHP and NHP has been proved to be a standardized and replicable orientation of the head; therefore, the NHP is representative of patients' images in daily life. 24,32 Previous studies have reported that the NHP could be changed after the correction of lower face asymmetry through orthognathic surgery. 24,25,31 Although no study has reported that rhinoplasty could change the NHP, its effect on facial aesthetics should not be neglected.…”

Section: Discussionmentioning

confidence: 99%

“…24,32 Previous studies have reported that the NHP could be changed after the correction of lower face asymmetry through orthognathic surgery. 24,25,31 Although no study has reported that rhinoplasty could change the NHP, its effect on facial aesthetics should not be neglected. According to the finding of this study, head tilting does affect facial perception and might interfere with surgeons' implementation of accurate surgical plans.…”

Section: Discussionmentioning

confidence: 99%

“…16,17,21,23 Head position is another factor that can interfere with people's judgment because it can mask facial asymmetry. [24][25][26] Both the Frankfort horizontal plane and natural head position (NHP) have been used as references for standardizing head position in facial analysis. 26 The aims of the present study were to determine the ideal nasal radix position under conditions of facial fluctuating asymmetry and to investigate the effects of head position on the perception of nasal deviation.…”

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confidence: 99%

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Ideal Nasal Radix Position in Fluctuating Facial Asymmetry

Hsu

Yen

Chang

et al. 2021

Journal of Craniofacial Surgery

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Background: Augmentation rhinoplasty had become increasingly popular among Asians. Failure to recognize nasal deviation before surgery may engender unsatisfactory outcomes because the deviation becomes prominently visible after surgery due to the central position of the nose. Ideal nasal radix positioning has yet to be addressed. The head position affects facial asymmetry judgements; however, its effect on rhinoplasty has never been studied. This study determined the ideal nasal radix position in facial fluctuating asymmetry and investigated the effects of the natural head position (NHP) on nasal deviation perceptions. Methods: A survey was conducted to compare different head and nasal radix horizontal positions using images of patients who underwent augmentation rhinoplasty. Images were retouched using editing software to adjust the head and nasal radix positions. The survey was performed using questionnaires involving 3 plastic surgeons and 3 laypersons, who were asked to determine the presence of nasal deviation and select the ideal nasal radix position among the retouched images. Results: Twenty patients who underwent primary rhinoplasty were included in this study. The recognition of nasal deviation was significantly higher in the NHP than in the compensatory head position. The surgeons and the laypersons considered the midsagittal line the most appropriate position of the nasal radix. Conclusions: Facial analysis for augmentation rhinoplasty should be performed with the patient's head in the NHP to prevent nasal deviation masking. The preferred nasal radix position in facial fluctuating asymmetry is the midsagittal line.Level of Evidence: Level V, descriptive study.

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Natural Head Postures of Patients With Facial Asymmetry in Frontal View Are Corrected After Orthognathic Surgeries

Cited by 11 publications

References 38 publications

The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis

The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis

Facial thirds–based evaluation of facial asymmetry using stereophotogrammetric devices: Application to facial palsy subjects

Ideal Nasal Radix Position in Fluctuating Facial Asymmetry

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