Simultaneous Correction of Hard- and Soft-Tissue Facial Asymmetry: Combination of Orthognathic Surgery and Face Lift Using a Resorbable Fixation Device

Abstract

The purpose of this study was to evaluate outcomes of simultaneous correction of the hard- and soft-tissue facial asymmetry with face lift procedure using a resorbable fixation device (Endotine Ribbon; Coapt Systems, Palo Alto, CA) during bimaxillary orthognathic surgery in cases with severe facial asymmetry. The samples consisted of 8 patients (mean age, 23.3 [SD, 4.4] years; 8 skeletal class III and 2 class II malocclusion) who received bimaxillary orthognathic surgery and a face lift procedure using a resorbable fixation device. Preoperative cephalometric evaluation of the maxillary occlusal plane cant and chin point deviation and data on surgical movement, site, time, and difficulty of face lift procedure were collected at 1 week before operation and during operation procedure. The amounts of lip cant between preoperation and postoperation were compared. Pain, stability of fixation, adverse effects, relapse, and patients` and surgeon`s satisfaction were evaluated at 6 months after operation. Initial and final amounts of the lip cant were 4.15 (SD, 0.53) and 0.80 (SD, 0.48) mm (correction rate, 76.8%). The face lift procedure took 28.4 (SD, 3.3) minutes without difficulty. There were no severe complications such as hematoma, facial nerve injury, and postoperative scar. By the patients` and surgeon`s view, all had satisfactory jowl elevation, lip canting correction, and achievement of the soft-tissue symmetry without evidence of recurrent asymmetry or loss of fixation. If the face lift procedure using a resorbable fixation device is done with proper vector control during orthognathic surgery, the hard-and soft-tissue facial asymmetry can be corrected simultaneously with satisfactory outcomes.