Nasal deformities associated with orthognathic surgery: Analysis, prevention, and correction

Any surgical procedure undertaken to correct or change facial features will have a resultant effect on nasal aesthetics. Orthognathic surgery is frequently performed to correct congenital and acquired dentofacial anomalies. The resultant changes in the maxillomandibular skeleton have consequences for the overlying soft tissue envelope of the face. This article will review the concepts of nasal analysis and aesthetics. It will then discuss the expected changes to the nasal appearance with orthognathic surgery, primarily LeFort I osteotomies, including a review of the literature that has attempted to quantify and predict these changes. A discussion of surgical techniques to control these changes as well as a discussion of adjunctive rhinoplasty will follow. Surgeons performing these procedures must be aware of the potential changes that can occur to the nasal structure so that they may appropriately plan adjunctive procedures and counsel their patients on both the expected aesthetic outcome and the possible need for subsequent surgeries.