Is Augmentation Required to Correct Malar Deficiency With Maxillary Advancement?

Area of Science:

• Craniofacial surgery
• Orthognathic surgery
• Aesthetic surgery

Background:

• Maxillary hypoplasia frequently coexists with malar deficiency.
• Le Fort I advancement is a common procedure for maxillary hypoplasia.
• Malar augmentation can be considered concurrently with maxillary advancement.

Purpose of the Study:

• To compare pre- and postoperative facial profiles of patients undergoing Le Fort I advancement.
• To evaluate the subjective perception of malar eminence projection changes.
• To assess the impact of simultaneous malar augmentation versus maxillary advancement alone.

Main Methods:

• Retrospective analysis of patients undergoing Le Fort I advancement with and without malar augmentation.
• Pre- and postoperative photographs assessed by laypersons and professionals.
• Visual analog scale used for malar region assessment.
• Statistical analysis including Wilcoxon signed rank test and t tests.

Main Results:

• Both groups perceived an increase in malar eminence projection postoperatively.
• Laypersons and professionals noted improved projection in both malarplasty and non-malar cohorts.
• Laypersons overestimated malar augmentation procedures; professionals demonstrated higher specificity in exclusion.

Conclusions:

• Le Fort I advancement typically leads to subjective improvement in malar projection for patients with maxillary hypoplasia.
• Maxillary advancement alone may suffice for optimal aesthetic outcomes.
• The decision for concurrent malar augmentation should align with patient preferences.