Computational modelling and optimisation of soft tissue outcome in cranio-maxillofacial surgery planning

Cranio-maxillofacial (CMF) surgery operations are associated with rearrangement of facial hard and soft tissues, leading to dramatic changes in facial geometry. Often, correction of the aesthetical patient's appearance is the primary objective of the surgical intervention. Due to the complexity of the facial anatomy and the biomechanical behaviour of soft tissues, the result of the surgical impact cannot always be predicted on the basis of surgeon's intuition and experience alone. Computational modelling of soft tissue outcome using individual tomographic data and consistent numerical simulation of soft tissue mechanics can provide valuable information for surgeons during the planning stage. In this article, we present a general framework for computer-assisted planning of CMF surgery interventions that is based on the reconstruction of patient's anatomy from 3D computer tomography images and finite element analysis of soft tissue deformations. Examples from our clinical case studies that deal with the solution of direct and inverse surgical problems (i.e. soft tissue prediction, inverse implant shape design) demonstrate that the developed approach provides a useful tool for accurate prediction and optimisation of aesthetic surgery outcome.