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Three-Dimensional Nasal Alterations in Le Fort I Advancement

Linear Measurements, Angles, Nasal Indices, and Volume Differences

Silva, Ana Maria Bettoni Rodrigues da, MS, PhD*; Magri, Laís Valencise, MS, PhD*; Osborne, Patrick Rocha, MS; Trivelatto, Alexandre Elias, MS, PhD; Sverzut, Cássio Edvard, MS, PhD; Silva, Marco Antônio Moreira Rodrigues da, MS, PhD*

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1125–1130
doi: 10.1097/SCS.0000000000005103
Clinical Studies

The maxillary advancement obtained by the Le Fort I osteotomy can also generate significant changes in the soft tissue of the nose and lips. The aim of this study was to compare the alterations in the soft tissue of the nose following the Le Fort I osteotomy maxillary advancement technique in a population of young adults submitted to orthognathic surgery. Seven men and 8 women aged between 23 and 45 underwent orthognathic surgery using the Le Fort I osteotomy and bilateral mandibular sagittal osteotomy. Sixty 3-dimensional images were analyzed (Vectra M3, Canfield, NJ) after labeling landmarks on the face and determining linear and angular measurements, proportion, and volume difference indices at the following intervals: preoperatively (baseline), then 2 months, 6 months, and 1 year after surgery. Following Le Fort I, there was an increase in the alar base, and reduction of nasal tip protrusion, nasal angles, and the nasal tip protrusion index (P < 0.05). There were no differences in the facial thirds, the nasal index, and angles of nasal and mentolabial convexity (P > 0.05). There was a difference in the volume of the nose only 2 months after surgery. The Le Fort I osteotomy caused significant alterations in linear, angular, and nasal proportion measurements. The volume differences were reversible in the early postoperative period and probably associated with edema. The possibility of variations in the size and shape of the nose should be presented to prospective patients preoperatively.

*Department of Restorative Dentistry

Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

Address correspondence and reprint requests to Laís Valencise Magri, MS, PhD, Av. do Café, Monte Alegre, School of Dentistry of Ribeirão Preto, São Paulo University (FORP/USP), 14040-904, Ribeirão Preto, Brazil; E-mail:

Received 25 June, 2018

Accepted 10 September, 2018

This research was financially supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Brazil) (project number: 2011/50424-6).

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.