Combined composite correction of orthognathic, nasal and cosmetic deformities

Many patients who present for orthognathic surgical correction have additional profile problems such as the position of the brow, the nasal anatomy, zygomatic hypoplasia, or positional chin problems independent of mandibular form. It is customary to assess the overall form and relationship of the facial structures but in the past surgical correction was carried out in separate stages. In other situations, for example craniofacial deformities, secondary cleft lip and palate anomalies, a single stage correction has been the goal. This has been aided by advances in anesthesia such as hypotension, autologous transfusions are now available and the surgical experience gained in other areas allows a reduction in operating time, thus single stage procedures have become the rule. In addition to this, it seems logical that all aspects of the deformity which is, in effect, inter-related should be corrected at the same time. Thus, composite corrections of the total facial region are practiced routinely, and this approach has given no cause for regret. In this paper, patients with a long-term follow-up will be presented.