Simultaneous Correction of Hard- and Soft-Tissue Facial Asymmetry

Abstract

The purpose of this study was to evaluate outcomes of simultaneous correction of the hard- and soft-tissue facial asymmetry with face lift procedure using a resorbable fixation device (Endotine Ribbon; Coapt Systems, Palo Alto, CA) during bimaxillary orthognathic surgery in cases with severe facial asymmetry. The samples consisted of 8 patients (mean age, 23.3 [SD, 4.4] years; 8 skeletal class III and 2 class II malocclusion) who received bimaxillary orthognathic surgery and a face lift procedure using a resorbable fixation device. Preoperative cephalometric evaluation of the maxillary occlusal plane cant and chin point deviation and data on surgical movement, site, time, and difficulty of face lift procedure were collected at 1 week before operation and during operation procedure. The amounts of lip cant between preoperation and postoperation were compared. Pain, stability of fixation, adverse effects, relapse, and patients' and surgeon's satisfaction were evaluated at 6 months after operation. Initial and final amounts of the lip cant were 4.15 (SD, 0.53) and 0.80 (SD, 0.48) mm (correction rate, 76.8%). The face lift procedure took 28.4 (SD, 3.3) minutes without difficulty. There were no severe complications such as hematoma, facial nerve injury, and postoperative scar. By the patients' and surgeon's view, all had satisfactory jowl elevation, lip canting correction, and achievement of the soft-tissue symmetry without evidence of recurrent asymmetry or loss of fixation. If the face lift procedure using a resorbable fixation device is done with proper vector control during orthognathic surgery, the hard- and soft-tissue facial asymmetry can be corrected simultaneously with satisfactory outcomes.

Three-dimensional evaluation of the correlation between lip canting and craniofacial planes

“… 3 However, asymmetry may persist when occlusal plane or lip canting persists. 4 In many cases of dentofacial deformities requiring orthognathic surgery, the inclination of the lip can be confirmed. Persistence of the lip canting after surgery results in reduced patient satisfaction.…”

Facial Flap Repositioning in Posttraumatic Facial Asymmetry

“…Recently, combination of various techniques such as bone contouring and fat graft injection prevailed and led to aesthetic results. Choi et al [ 6 ] reported bimaxillary orthognathic surgery combined with a face lift procedure plus the use of a resorbable fixation device. In this case, we judged that the patient did not require more facial bone surgery, yet face lift or fat graft injection did not seem sufficient to correct the asymmetry.…”

Correction of Lip Canting Using Bioabsorbables during Orthognathic Surgery

“…In our small group, except for patient 1 who received mandibular surgery alone, the correction rate six months after the operation was 48.9%. Choi et al [ 15 ] reported that correction rate of the lip cant was approximately 76.8% six months after simultaneous orthognathic surgery and the Endotine lift. In this study, the correction rate of the lip cant was 54.2% six months after the operation, and an average 74.2% three years after the operation.…”