title: Cosmetic procedures in orthognathic surgery.
abstract: OBJECTIVE
  Orthognathic surgery produces cosmetic and functional effects, and patients should be evaluated for additional cosmetic improvements beyond those possible with orthognathic surgery. Soft tissue procedures can be performed on an outpatient basis in an office environment and can be combined with orthognathics and delayed in a second stage.
  
  
  METHODS
  Systematic accurate facial evaluation is necessary to focus on cosmetic soft tissue problems. Features that make the patient look unattractive, old, tired, out of shape, weak, or sad must be identified by accurate clinical analysis and 3-dimensional planning. Then it will be possible to select the treatment plan according to the patient's input, prioritizing the additional cosmetic improvements that can be added to primary surgery.
  
  
  RESULTS
  It is particularly important to review the results and the patient's satisfaction by clinical examination, a questionnaire, and with 3-dimensional pictures, and to understand if the treatment options have been accurately chosen and their lasting effect on follow-up. The treatment sequence is analyzed, and if there are residual defects, a secondary cosmetic procedure can be planned to complete the result.
  
  
  CONCLUSIONS
  The surgeon's goal must be the simultaneous treatment of malocclusions and facial esthetic disharmonies, and orthognathic surgical procedures and facial cosmetics must be performed simultaneously, if possible. Residual defects must be treated after at least 6 to 12 months.
authors.affiliation: Chirurgia Maxillo Facciale e Odontostomatologia, Policlinico Borgo Roma, Verona, Italy.
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Nocini
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiarini
authors.forename: Dario
authors.initials: D
authors.lastname: Bertossi
mesh_terms: D000328:Adult; D002680:Chin / Q000601:surgery; D003357:Cosmetic Techniques; D004955:Esthetics, Dental; D005145:Face / Q000033:anatomy & histology; D005147:Facial Bones / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D015187:Lipectomy; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D024343:Open Bite / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D012225:Rhinoplasty; D011795:Surveys and Questionnaires; D014716:Vertical Dimension; D055815:Young Adult; D015050:Zygoma / Q000601:surgery