The Role of Orthognathic Surgery in Perioral Facial Aesthetics

ABSTRACT

Orthognathic surgery is widely applied to correct congenital and acquired facial skeletal problems related to malocclusion, temporomandibular joint disorders, and obstructive sleep apnea. The secondary benefit of enhanced perioral aesthetics is becoming more accepted as a rationale for corrective jaw surgery. This article presents the plastic surgeon with a systematic and detailed clinical approach to evaluating the patient with aesthetic problems in the perioral region. Emphasis is placed on recognition of dental- and skeletal-based problems and in understanding their impact on perioral aesthetics. The need for full and complete diagnosis of perioral problems along with a multidisciplinary approach for optimal management is discussed. A brief overview of the effect of osteotomies on soft tissues of the face is presented.

KEYWORDS

Orthognathic - perioral - aesthetics - cosmetic

REFERENCES

• 1 Baldwin D C. Appearance and aesthetics in oral health.  Commun Dent Oral Epidemiol . 1980;  8 244-256
• 2 Cunningham S, Hunt N, Feinmann C. Psychological aspects of orthognathic surgery: a review of the literature.  Int J Adult Orthod Orthognath Surg . 1995;  10 159-172
• 3 Whitaker L, Bartlett S. Skeletal alterations as a basis for facial rejuvenation.  Clin Plast Surg . 1991;  18 197-203
• 4 Nocini P. Aesthetic improvements in the mid-lower face skeletal surgery.  Fac Plast Surg . 1999;  15 285-296
• 5 Edgerton M, Knorr N. Motivational patterns of patients seeking cosmetic (esthetic) surgery.  Plast Reconstr Surg . 1971;  48 551-557
• 6 Panula K, Finne K, Oikarinen K. J Oral Maxillofac Surg .  2001;  59 1128-1136
• 7 Zweig B E. Esthetic analysis of the cervicofacial region.  Atlas Oral Maxillofac Surg Clin North Am . 2000;  8 1-11
• 8 Benson K, Laskin D. Upper lip asymmetry in adults during smiling.  J Oral Maxillofac Surg . 2001;  59 396-398
• 9 Furnas D W. The retaining ligaments of the cheek.  Plast Reconstr Surg . 1989;  89 11-16
• 10 Lines P A, Steinhauser E W. Soft tissue changes in relationship to movement of hard tissue structures in orthognathic surgery: a preliminary report.  J Oral Surg . 1974;  32 891
• 11 Betts N J, Dowd K F. Soft tissue changes associated with orthognathic surgery.  Atlas Oral Maxillofac Surg Clin North Am . 2000;  8 13-38
• 12 Betts N J. Techniques to control nasal features.  Atlas Oral Maxillofac Surg Clin Am . 2000;  8 53-69
• 13 Sarver D M, Rousso D R, White R P. Adjunctive esthetic surgery. In: Proffit WR, White RP, Sarver DM, eds. Contemporary Treatment of Dentofacial Deformity St. Louis, MO: Mosby; 2003: 394-415
• 14 Matarasso A, Elias A, Elias R. Labial incompetence: a marker for progressive bone resorption in silastic chin augmentation.  Plast Reconstr Surg . 1995;  98 1007-1014
• 15 Ziccardi V B. Adjunctive cervicofacial liposuction.  Atlas Oral Maxillofac Surg Clin North Am . 2000;  8 81-97