Incidence of Deformational Plagiocephaly in Patients of Facial Contouring Surgery

Deformational plagiocephaly (DP), a distortion of a baby's head shape due to sleeping position, can cause ear malposition, facial asymmetry, and malocclusion. Helmet therapy only surfaced as a recommended treatment in severe cases. However, the number of patients who have grown up with severe deformities without treatment has increased. It is unclear whether these deformities spontaneously resolve during growth. This study investigated the incidence of examining cranial deformities in patients seeking facial contour surgery. Patients presenting with facial asymmetry, jaw deformity, or other facial concerns were included. Complaints were categorized as malar asymmetry, lateral malar protrusion, or anterior malar protrusion. DP was classified using the Argenta system based on cone-beam CT images. Among patients with malar asymmetry (n=32), Type IV deformities were most frequent (84.4%), followed by Type I (12.5%) and Type II (3.1%). Anterior protrusions (n=19) comprised Type I (47.4%), Type II (42.1%), and Type IV (10.5%), whereas lateral protrusions (n=47) included Type II (51.1%), Type I (40.4%), and Type IV (6.4%). Type IV malar asymmetry was significantly prevalent (P<0.05). Severe untreated craniofacial deformities may persist by impacting facial structures including the cheeks and jaw. These findings suggest that untreated severe DP in infancy can cause residual facial deformities, thereby highlighting the importance of early intervention to avoid severe distortion.