Concurrent Le Fort I osteotomy and aesthetic rhinoplasty: outcomes and complications

Background/objectives: The dentofacial deformities are related to deviations from normal facial proportions and changes in dental relationships and may result in aesthetic maxillo-mandibular alterations. The nose is an important aesthetic element of facial expression where rhinoplasty plays an important role. The simultaneous rhinoplasty and orthognathic surgery, especially Le Fort I osteotomy, is still widely debated in the literature. Most common criticisms are due to unpredictability in nasal position and morphology after maxillary osteotomy, especially after impaction and advancement. The objective of this study was to evaluate patients that underwent concurrent rhinoplasty and orthognathic surgery (Le Fort I osteotomy), based on outcomes and complications.

Methods: A retrospective study was conducted from January 2009 to 2012. We studied 17 patients that underwent concurrent Le Fort I osteotomy and rhinoplasty. Data collected were: dentofacial deformity, surgical technique, duration of surgery, patient satisfaction, and complications.

Results: Age ranged from 16 to 35 years, mean 24.5 years. Of these, 12 were female and 5 male. Regarding dentofacial deformity, 10 were Class III, 3 were Class II (long face), and 4 had anterior open bite. All patients underwent maxillary osteotomy Le Fort I type, of which 7 underwent concomitant mandibular bilateral sagittal split osteotomy (6 advancement and 1 setback). Basilar osteotomy of the chin was performed in 11 patients. From the aesthetic point of view, all patients were satisfied. With regard to complications, 3 patients presented paresthesia in the region of the inferior alveolar 6 months after surgery, 1 patient developed seroma in the region of the rib cartilage harvesting, 1 patient underwent revision for nose asymmetry (new osteotomy on left side).

Conclusions: Combining rhinoplasty with maxillary Le Fort I osteotomy has showed excellent results to correct aesthetic defects and occlusion, with excellent satisfaction rates and with a low complication rate.

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Concurrent Le Fort I osteotomy and aesthetic rhinoplasty: outcomes and complications

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