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The influence of tissue redraping after Le Fort I type osteotomy

  • Author Footnotes
    1 Equal contribution, Co-first authors.
    Ellen Van Opstal
    Footnotes
    1 Equal contribution, Co-first authors.
    Affiliations
    Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium

    Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium

    Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium
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  • Author Footnotes
    1 Equal contribution, Co-first authors.
    Elke Van de Casteele
    Footnotes
    1 Equal contribution, Co-first authors.
    Affiliations
    Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium

    All for Research vzw, Harmoniestraat 68, 2018 Antwerp, Belgium

    Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
    Search for articles by this author
  • Adélaide Carlier
    Affiliations
    Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, Chemin du grand Revoyet, 69495 Pierre Benite Cedex, France
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  • Herman Vercruysse Jr
    Affiliations
    Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium

    Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium
    Search for articles by this author
  • Nasser Nadjmi
    Correspondence
    Corresponding author at: OMFS at the University of Antwerp (UA), Belgium and Director of the team for Cleft & Craniofacial anomalies at the Antwerp University hospital, Belgium.
    Affiliations
    Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium

    All for Research vzw, Harmoniestraat 68, 2018 Antwerp, Belgium

    Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium

    Department of Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Harmoniestraat 48, 2018 Antwerp, Belgium
    Search for articles by this author
  • Author Footnotes
    1 Equal contribution, Co-first authors.
Published:December 14, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.11.283

      Abstract

      Elongation of the upper lip, in particular the philtrum, and nose widening are common postoperative changes after a Le Fort I osteotomy. These changes can be induced by the transection of soft tissue and loosening of the underlying musculature. A methodology for soft tissue redraping was developed to limit these undesirable nasolabial changes. This study evaluates the effectiveness of the technique and influence of maxillary translocation on the nasolabial form. Anthropometric measurements, lip, philtrum length, and nose width, were taken two weeks prior to, and one year after, surgery. The mean postoperative changes were minimised to less than 1mm except for lip length in the extrusion groups, which was less than 1.5mm. Statistical analysis showed a stable result for lip length after maxillary advancement and/or intrusion as limited lengthening mainly occurred at the vermilion. Conversely, lip lengthening after extrusion mainly occurred at the philtrum. The mean nose width was maintained after maxillary advancement, decreased after extrusion, and increased after intrusion. The type of maxillary translocation only influenced the nasolabial soft tissue in case of intrusion and extrusion, not after advancement.

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