title: Management of maxillofacial hard and soft tissue discrepancy in Möbius sequence: clinical report and review of the literature.
abstract: BACKGROUND
  Möbius sequence implies significant maxillofacial hard and soft tissue anomalies which nevertheless have not been addressed thoroughly in the scientific literature.
  
  
  OBJECTIVE
  To report a case of complete Möbius sequence and discuss the management of maxillofacial hard and soft tissue anomalies.
  
  
  METHODS
  A 15-year-old girl with complete Möbius underwent bimaxillary orthognathic surgery, horizontal sliding genioplasty and mentalis muscles reinsertion. Vestibuloplasty and bilateral canthopexy were performed to address lip deficiency and attenuate hypotonic depression of the lower eyelids, respectively. Cheekbone augmentation was achieved with an autologous fat transfer. The authors review the scientific literature and discuss surgical planning for the correction of maxillofacial discrepancy.
  
  
  RESULTS
  The patient exhibits significant functional and aesthetic improvement, with excellent integration of the transferred fat and adequate bone healing.
  
  
  CONCLUSIONS
  Orthognathic bimaxillary surgery combined to soft tissue management can improve aesthetics and orofacial function in Möbius patients, thereby contributing to facilitate social interaction and increase patients' self-esteem.
authors.affiliation: Institute of Maxillofacial Surgery and Implantology, Teknon Medical Center, Vilana, 12, D-185, 08022 Barcelona, Spain. raquelguijarro@comv.es
authors.forename: Raquel
authors.initials: R
authors.lastname: Guijarro-Martínez
authors.forename: Federico
authors.initials: F
authors.lastname: Hernández-Alfaro
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D002610:Cheek / Q000601:surgery; D002680:Chin / Q000601:surgery; D004954:Esthetics; D005143:Eyelids / Q000601:surgery; D005152:Facial Muscles / Q000601:surgery; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D020331:Mobius Syndrome / Q000601:surgery*; D024343:Open Bite / Q000601:surgery; D009971:Orthodontics, Corrective; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D019651:Plastic Surgery Procedures; D014727:Vestibuloplasty