Facial soft tissues after bimaxillary orthognathic surgery of class III malocclusions

Aim: The purpose of this study is to assess cephalometrically the hard and the soft tissue response of skeletal Class III patients treated by bimaxillary orthognathic surgery, and to evaluate the correlation between the two. Materials and Methods: Twenty-one patients, 8 men and 13 women, aged 18 to 35 years, had undergone two-jaw orthognathic surgery with maxillary Le Fort I advancement osteotomy and mandibular setback osteotomy, either bilateral sagittal split or vertical ramus osteotomy; with no additional surgical procedures on the mid-face or chin. Results: After the bimaxillary surgery was underlined a strong correlation in the horizontal and vertical direction between all the selected landmarks of the lower lip and chin, but only between superior labial sulcus and point A in the upper lip in the horizontal direction. Conclusions: The relationship between hard tissue surgery and the effect which it has on the overlying soft tissue is extremely important in predicting final facial profile and esthetical changes. Treatment planning for patient who require orthognathic surgery should include both a hard tissue and soft tissue cephalometric analysis. Although the hard tissue analysis will show the nature of the existing skeletal discrepancy, it is incomplete in providing information concerning the facial form and proportions of the patient. Patients may appear either more or less convex in their profiles than is indicated by their hard tissues because of differences in thickness of soft tissue, particularly at the junction of nose and upper lip and in the region of the chin.