Analysis of Soft Tissue Change After Maxillary Advancement Without Vestibular Horizontal Mucosal Incision Beneath the Nose Area to Avoid Alar Base Widening

Objective: Alar base widening and nasal tip upward movement are undesirable soft tissue changes taken place after Le Fort I type osteotomy. We developed a modified technique of one without making horizontal vestibular mucosal incision beneath nose area to preserve the soft tissue shape. In this paper, we describe soft tissue changes around nose and upper lip after this modified technique.

Methods: For Le Fort I type osteotomy, horizontal vestibular mucosal incisions from canine to molar area are made in both sides. Osteotomy to move total maxillary alveolar segment is made with PED only in the maxillary anterior and posterior bony wall portion. Down fracture is performed with a pair of separators without a nasal septum osteotomy. The bone fragments can be repositioned without dissecting the nasal septum, and an alar base cinch suture is no need. Pre and Post-operative cephalometric analysis were compared each other.

Results and Conclusions: The soft tissue shape of upper lip and nose is preserved without the use of alar base cinch suture. Maxillary Advancement with Le Fort I osteotomy is able to perform without vestibular horizontal mucosal incision beneath the nose area to avoid alar base widening.