Three-dimensional facial morphometric assessment of soft tissue changes after orthognathic surgery

Objective. in this study, a 3-dimensional system with landmark representation of the soft tissue facial surface was applied for the evaluation of facial changes occurring after orthognathic surgery in 5 patients. Study design. Standardized facial landmark acquisitions were performed before and 1 year after surgery (combined maxillary Le Fort I and sagittal mandibular osteotomies). The 3-dimensional coordinates of 22 facial soft tissue points were collected on each subject through use of a computerized noninvasive method and used to calculate a set of selected parameters. Results. Three-dimensional soft tissue analysis of patients was in general agreement with the type of surgery performed, with volumetric contraction of the lower facial third and expansion of the middle facial third. Moreover, negative effects of surgery were quantified (eg, an increase in alar base dimensions); the global asymmetry of facial soft tissues was increased by intervention, but asymmetry in the lower facial third was reduced. Conclusions. The method used in this study proved useful as a complementary diagnostic aid, enabling quantitative evaluation of the final soft tissue results of surgery, which were proportional to those expected on the basis of the type of treatment and skeletal data.