Midface and lower face soft tissues after double-jaw orthognathic surgery

Aim: The purpose of this study was 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. Material and methods: Forty-nine patients, 20 men and 29 women, aged 19 to 37 years, had undergone two-jaw orthognathic surgery, with no additional surgical procedures on the midface or chin. Treatment planning for patient who requires 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. 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 (p<0.01). 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. 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.