title: Soft tissue profile changes following mandibular advancement and setback surgery an average of 12 years postoperatively.
abstract: OBJECTIVE
  The aim of this study was to assess long-term changes in position of soft tissue landmarks following mandibular advancement and setback surgery.
  
  
  METHODS
  Twenty-seven patients (14 women, 13 men; mean age, 36 years) who had undergone either mandibular advancement (15 patients) or setback surgery (12 patients), were available for a long-term follow-up an average of 12 years postoperatively. In all of these cases, lateral cephalometric radiographs taken immediately before operation, at 1 week, 14 months, and 12 years postoperatively, were studied.
  
  
  RESULTS
  During the 14 months postoperatively, soft tissue chin and mentolabial fold followed its underlying hard tissue in all patients. A continuous skeletal relapse was observable 12 years after mandibular advancement, but soft tissue chin moved more in an anterior direction. After mandibular setback, soft and hard tissue landmarks remained almost unchanged. Over the entire observation period, a thickening of soft tissue at pogonion was generally seen, and particularly a thickening of the whole chin in the setback group. All patients showed a significant lengthening and thinning of the upper lip. In all except 2 males, the patient's body weight increased markedly.
  
  
  CONCLUSIONS
  In contrast to the immediate postoperative stage, soft tissue changes observed an average of 12 years after the primary operation do not directly follow the movements of the underlying skeletal structure. The soft tissue profile changes observed over such a long term seem to be influenced not only by the underlying skeletal structure but also by other factors such as weight gain and aging process.
authors.affiliation: Department of Cranio- and Maxillofacial Surgery, University of Bern, Inselspital, Bern, Switzerland. eggensperger@insel.ch
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Eggensperger
authors.forename: Olivier
authors.initials: O
authors.lastname: Lieger
authors.forename: Urs
authors.initials: U
authors.lastname: Thüer
authors.forename: Tateyuki
authors.initials: T
authors.lastname: Iizuka
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000033:anatomy & histology; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000033:anatomy & histology; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000033:anatomy & histology / Q000601:surgery*; D019186:Mandibular Advancement; D008875:Middle Aged; D009666:Nose / Q000033:anatomy & histology; D010027:Osteotomy / Q000379:methods*; D011378:Prognathism / Q000601:surgery; D063173:Retrognathia / Q000601:surgery; D012189:Retrospective Studies; D015430:Weight Gain / Q000502:physiology