Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients

The aim of this before-after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery.

A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1.74 mm of mandibular setback (intraoral vertical ramus osteotomy, 7.71 ± 2.33 mm in men, and 6.74 ± 1.16 mm in women). Data were acquired via 2D frontal photographs. We compared pretreatment baseline (T ₁), preoperative postorthodontic treatment (T ₂), and postoperative (T ₃) anthropometric measurements using repeated-measures ANOVA and Bonferroni tests (α = 0.05).

The 20 patients (12 men, 8 women) were aged 21.85 ± 1.75 years. Between T ₁ and T ₂, nasal width, cutaneous upper labial heights increased overall; cutaneous lower labial height decreased (P < 0.05). Between T ₂ and T ₃, nasal width, widths of the philtrum and mouth, cutaneous upper-lip height, vermilion height of the lower lip, lateral upper-lip height increased; the upper-lip vermilion height and cutaneous lower lip height decreased (P < 0.05). The changes ranged between 0.5 and 5 mm.

The applied orthognathic surgery procedures might widen the alar base and mouth width. It might increase the lateral upper-lip height, vermilion height of the lower lip, and cutaneous and overall upper-lip heights while reducing upper-lip vermilion height and shortening the overall lower-lip height.