title: Assessment of three-dimensional nasolabial response to Le Fort I advancement.
abstract: BACKGROUND
  Le Fort I advancement induces soft tissue changes to the nasolabial region. The correlation of sagittal skeletal movement to soft tissue alteration has been studied using 2D methods. However, the influence of maxillary advancement has not been adequately assessed using three-dimensional means. The purpose of this study is to analyze nasolabial changes following Le Fort I advancement using 3D photometric measurements.
  
  
  METHODS
  Patient demographic information and their amount of advancement were tabulated. Pre- and postoperative 3D photographs (3D VECTRA photosystem, Canfield, Fairfield, NJ) were recorded. Nasolabial anthropometric measurements were performed using the corresponding 3D post-processing software (Mirror). Six month minimum follow-up elapsed before final evaluation.
  
  
  RESULTS
  Forty-four 3D photo data sets were included. Mean maxillary advancement was 5.5 (±1.9) mm. Male/female ratio was 0.7 with a mean age of 16.7 years. Significant increases (p < 0.0001) were seen in the alar base, alar widths, nostril width, and in the soft triangle and lateral alar angles. Significant decreases (p < 0.0001) were noted in the nasofrontal angle and in nostril height. A significant (p < 0.05) increase of the nasal tip, columella and upper lip projection was seen. Philtral height showed no significant changes (p > 0.05) after maxillary advancement. No significant correlation (p > 0.05) between the degree of soft tissue changes and the amount of maxillary advancement was found.
  
  
  CONCLUSIONS
  Le Fort I advancement significantly impacts the nasolabial soft tissue envelope. The 3D soft tissue changes are predictable and similar for any advancement up to 10 mm.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Philipp
authors.initials: P
authors.lastname: Metzler
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Geiger
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Dental Section, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand.
authors.forename: Irin
authors.initials: I
authors.lastname: Sirisoontorn
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT 06520, USA. Electronic address: derek.steinbacher@yale.edu.
authors.forename: Derek M
authors.initials: DM
authors.lastname: Steinbacher
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry / Q000379:methods; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D060052:Nasolabial Fold / Q000000981:diagnostic imaging*; D019340:Osteotomy, Le Fort / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anthropometric; Le Fort I; Nasolabial; Three-dimensional