Nasolabial Morphologic Changes After a Le Fort I Osteotomy: A Three-Dimensional Anthropometric Study

After a Le Fort I osteotomy, nasal and labial changes are sometimes undesirable. The aim of this study was to perform a three-dimensional evaluation of the morphologic changes of the nose and lips after a Le Fort I osteotomy with a three-dimensional laser scanner. Twelve female patients who underwent a Le Fort I osteotomy with bilateral sagittal split ramus osteotomy (mean age, 24.2 y) were selected. Three-dimensional facial morphology was measured immediately after surgery and 6 months after surgery with a three-dimensional laser scanner. Analysis of the three-dimensional data was performed with three-dimensional image analyzing software. The evaluation was performed by (1) linear and angular analyses of landmarks, (2) three-dimensional curvature, and (3) visual qualitative analysis using superimposing mapping images. The results were compared control with data taken from volunteers (mean age, 24.5 y). Lateral expansion of nasal alae was commonly observed after surgery. The labial changes were mainly due to movements of the jawbone, and obvious flattening was not detected in this study. There was no relationship between the nasal changes and maxillary advancement. The nasal morphologic changes after a Le Fort I osteotomy consist mainly of a widening of the nasal alae caused by the release of the muscle insertion and their retraction. This change was not influenced by the direction of maxillary movements.