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Clockwise and Counterclockwise Le Fort I Movements Influence Nasolabial Morphology Differently
Rajendra Sawh-Martinez1, Alex M Lin1, Christopher R DeSesa1
1From the Department of Surgery, Section of Plastic Surgery, Yale University School of Medicine; and the Frank H. Netter MD School of Medicine, Quinnipiac University.
Plastic and Reconstructive Surgery
|September 7, 2018
Summary
Le Fort I maxillary advancements impact nasal shape. Counterclockwise movements significantly widen the nose and mouth, while clockwise movements show minimal changes. Understanding these differences is crucial for surgical planning.
Area of Science:
- Craniofacial surgery
- Orthognathic surgery
- Plastic surgery
Background:
- Le Fort I maxillary advancements can alter nasal proportions.
- Limited data exists on 3D nasal changes from differential lateral plane adjustments during Le Fort I advancements.
- This study investigates nasolabial soft-tissue changes following clockwise and counterclockwise Le Fort I repositioning.
Purpose of the Study:
- To analyze and compare nasolabial soft-tissue changes after clockwise versus counterclockwise Le Fort I maxillary advancements.
- To provide data on 3D nasal alterations resulting from differential lateral plane adjustments.
- To inform surgical planning and patient counseling regarding aesthetic outcomes.
Main Methods:
- Retrospective analysis of patients undergoing single-piece Le Fort I advancements.
- Patients were divided into clockwise and counterclockwise repositioning groups.
- Preoperative and postoperative 3D photographs were analyzed for anthropometric measurements using specialized software.
Main Results:
- Counterclockwise movement significantly increased alar width (3.6 mm), alar base width (1.6 mm), oral width (3.2 mm), and lip projection (3.4 mm).
- Clockwise movement showed no statistically significant changes in measured nasolabial parameters.
- Largest positional changes with clockwise movement were observed in alar width (2.7 mm) and alar base width (1.7 mm), though not statistically significant.
Conclusions:
- Clockwise and counterclockwise Le Fort I advancements yield distinct postoperative nasolabial morphologies.
- Counterclockwise movements result in significant nasal and oral width increases.
- The findings highlight the differential impact on nasolabial appearance, essential for treatment planning.
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