Three-Dimensional Soft Tissue Change of the Malar Region with High Le-Fort 1 Advancement: Implications for Aesthetic Malar Contouring. D Morris, B Rosett, L Zhao, and P Patel.
Presentation: Three-Dimensional Soft Tissue Change of the Malar Region with High Le-Fort 1 Advancement: Implications for Aesthetic Malar Contouring.
Authors: D Morris, B Rosett, L Zhao, and P Patel
Source: The Aesthetic Meeting 2014, San Francisco, CA, USA
Date: April 2014
Purpose: While orthognathic procedures are performed for a number of clinical scenarios, a fundamental goal is to reposition the facial skeletal components so as to improve both function as well as aesthetics. For patients with malar hypoplasia, modification of the traditional Le Fort 1 osteotomy, the workhorse procedure for maxillary repositioning, allows one to carry the osteotomy superolaterally to advance the zygoma, and thereby simultaneously augment the malar region. With recent advances in three-dimensional (3D) imaging it is now possible to plan such three-dimensional skeletal movements preoperatively, to accurately execute these movements intraoperatively through customized cutting guides, and to 3-dimensionally quantify the resultant skeletal and soft tissue change. The goal of this study is to quantify the relationship between underlying skeletal change and overlying soft tissue change in the zygoma region for a series of patients who underwent high LeFort 1 osteotomy that included zygoma advancement. While soft tissue change has been related to the underlying skeletal movement for some facial areas (e.g. chin with genioplasty), this has not been well described for the malar region and this may relate to the high revision rates for malar alloplastic augmentation cited in the literature. It is possible that data acquired through this study can be applied in the context of planning malar augmentation and reduction procedures.