Facial Aesthetics, Evaluation of Facial Soft Tissue Changes for Orthognathic Surgery
Prof. M Anwar Bamber (London, UK)
This lecture will explore the following areas;
- The concept of facial aesthetics and perception differences between various ethnic groups.
- Review of ethnic facial aesthetics.
- Soft tissue changes relevant to facial deformity surgery.
- Possible solutions to the questions that arise before and after orthognathic surgical correction of facial disharmony, using a three-dimensional imaging tool, the “Optical Surface Scanner”.
The evaluation of the facial soft tissue components shows that although the multi-dimensional judgment of attractiveness may differ from one individual to another, the concept of facial beauty was to a great extent shared by all. The facial deformity diagnosis, treatment planning, pre and postsurgical orthodontics, surgical prediction and the evaluation of the outcome of orthognathic surgery are just as challenging as the surgical procedure.
Surgical planning based on a reliable prediction of outcome depends on the data from accurate and reproducible postoperative measurements. This presentation will elaborate how the “Optical Surface Scanner” could capture soft tissue changes and measure the linear, area and volumetric differences after the surgical correction of Class II and Ill facial deformities. The facility of these measurements is eminently suitable for clinical practice.
Many regions of the face, which had not been previously investigated, e.g. paranasal, supracomissural and subcomissural (the angles of the mouth) regions were accessible for measurement using the optical surface scanner. This enabled the lips to be investigated in detail, differentiating the responses of the upper and the lower vermilion borders. Changes in the chin particularly in relation to the labiomental groove and the lower lip are important. As has been established, the pogonion moves as a 1:1 ratio compared to the underlying skeletal change. However the labiomental groove moved 80-90% of the skeletal change reflecting the opening of the groove with advancement. The lower lip showed 60-70% conformity of movement of the mandible both with advancements and setbacks. The three-dimensional surface scans confirmed the eversion of the lower lip with a mandibular setback.