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Facial appearance prediction for orthognathic surgery with diffusion models.

Jungwook Lee1, Xuanang Xu1, Daeseung Kim2

  • 1Department of Biomedical Engineering and the Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA.

Medical Image Analysis
|January 16, 2026
PubMed
Summary
This summary is machine-generated.

This study introduces FAPOS, a new AI framework for orthognathic surgery planning. It predicts optimal facial appearance to guide skeletal changes, improving patient-specific aesthetic outcomes.

Keywords:
Diffusion modelLarge-scale pre-trainingOrthognathic surgerySoft-tissue-driven planning

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Area of Science:

  • Computer Vision
  • Medical Imaging
  • Artificial Intelligence

Background:

  • Orthognathic surgery corrects facial deformities but conventional planning is bone-driven, limiting aesthetic optimization.
  • Current methods struggle with surgeon bias and predicting patient-specific soft-tissue outcomes.
  • A soft-tissue-driven approach aims to predict ideal facial appearance first, then determine necessary skeletal adjustments.

Purpose of the Study:

  • To introduce FAPOS (Facial Appearance Prediction for Orthognathic Surgery), a novel framework for soft-tissue-driven surgical planning.
  • To enable direct prediction of a patient-specific, normal-looking 3D facial outcome from pre-operative scans.
  • To overcome limitations in data scarcity and lack of correspondence in facial datasets.

Main Methods:

  • Developed FAPOS, a transformer-based latent diffusion model for 3D facial outcome prediction.
  • Utilized a dense 282-landmark representation trained on 44,602 public 3D faces.
  • Employed a three-phase training pipeline: geometric encoding, latent diffusion modeling, and patient-specific conditioning.

Main Results:

  • FAPOS successfully predicts normal-looking 3D facial outcomes for orthognathic surgery planning.
  • The framework demonstrates improved facial symmetry and identity preservation compared to prior methods.
  • Quantitative and qualitative analyses confirm FAPOS's superior performance.

Conclusions:

  • FAPOS represents a significant advancement towards enabling soft-tissue-driven orthognathic surgical planning.
  • The predicted optimal facial target facilitates the estimation of required skeletal adjustments.
  • This approach allows for more patient-specific aesthetic optimization in craniomaxillofacial surgery.