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Quantifying Facial Rejuvenation Following Orthognathic Surgery
Alexandra Junn
*, Karen Li, Varsha Harish, Daisy L. Spoer, Andrew Abadeer, Stephen Baker
Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington,
Background: Patients who exhibit mandibular or maxillary retrusion may present for lower facial rejuvenation earlier than patients who demonstrate normal mandibular and chin projection; altering the skeletal foundation upon which the soft tissue is supported expands the overlying soft tissue, which results in a rejuvenative effect. The purpose of this study was to quantify the 3-dimensional soft tissue changes that take place in response to underlying osseous movement associated with planned orthognathic surgery.
Methods: Pre- and post-operative images were obtained on Vectra. Surface maps of the 2 images were aligned by manually registering reproducible landmarks unchanged in surgery: medial and lateral canthi, glabella, left and right tragus. Surface area and volume were calculated for the lower facial third as well as 3 distinct regions of the face corresponding to the nasolabial fold, marionette and jowl, and lateral cheek. Color maps or topographical maps were created to identify facial areas most altered in terms of projection.
Results: A total of 22 patients were included in the analysis. Of those, 14 were female, and average age at surgery was about 31 years. Mean follow up time from date of surgery to post-operative imaging was 333 days. All patients underwent Lefort I advancement and BSSO, while 7 also underwent concurrent genioplasty. Mean advancement of the LeFort I segment was 8.75 mm. The mean total volume increase in the lower third of the face among all patients was 22.9 cc. Volume expansion in segments 1, 2, and 3 were 1.44, 5.33, and 4.72 cc respectively. Compared to those only undergoing Lefort/BSSO, patients undergoing concurrent genioplasty experienced a greater increase in volume expansion (32.76 cc vs. 19.29 cc, P=0.17).
Conclusions: This is the first study to quantify the 3D volumetric changes in the soft tissue in in patients undergoing orthognathic surgery.
Patient Demographics
Age at surgery (years) | 30.93 ± 17.34 |
Gender | |
Male | 8 (36.36%) |
Female | 14 (63.64%) |
Time to follow up (days) | 333.9 ± 423.33 |
Type of Surgery | |
LeFort I advancement | 22 (100%) |
BSSO | 22 (100%) |
Genioplasty | 7 (31.82%) |
Rhinoplasty | 1 (4.55%) |
Fat Grafting | 1 (4.55%) |
Region 1Region 2Region 3
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