Three-Dimensional Nasal Alterations in Le Fort I Advancement: Linear Measurements, Angles, Nasal Indices, and Volume Differences.

The maxillary advancement obtained by the Le Fort I osteotomy can also generate significant changes in the soft tissue of the nose and lips. The aim of this study was to compare the alterations in the soft tissue of the nose following the Le Fort I osteotomy maxillary advancement technique in a population of young adults submitted to orthognathic surgery. Seven men and 8 women aged between 23 and 45 underwent orthognathic surgery using the Le Fort I osteotomy and bilateral mandibular sagittal osteotomy. Sixty 3-dimensional images were analyzed (Vectra M3, Canfield, NJ) after labeling landmarks on the face and determining linear and angular measurements, proportion, and volume difference indices at the following intervals: preoperatively (baseline), then 2 months, 6 months, and 1 year after surgery. Following Le Fort I, there was an increase in the alar base, and reduction of nasal tip protrusion, nasal angles, and the nasal tip protrusion index (P < 0.05). There were no differences in the facial thirds, the nasal index, and angles of nasal and mentolabial convexity (P > 0.05). There was a difference in the volume of the nose only 2 months after surgery. The Le Fort I osteotomy caused significant alterations in linear, angular, and nasal proportion measurements. The volume differences were reversible in the early postoperative period and probably associated with edema. The possibility of variations in the size and shape of the nose should be presented to prospective patients preoperatively.