Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction

Raffaini, Mirco; Pisani, Claudia

doi:10.1016/j.ijom.2014.12.017

Cited by 28 publications

(12 citation statements)

References 34 publications

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“…The goal of successful orthognathic surgery (OGS) is to correct malposition of the jaw bone, resolve related malocclusions, achieve aesthetic correction of the facial appearance, and to treat problems related to the upper respiratory tract [ 1 , 2 ]. Class III malocclusions comprise approximately 48% of the total number of malocclusions in the Republic of Korea.…”

Section: Introductionmentioning

confidence: 99%

Computer-Aided Surgical Simulation for Yaw Control of the Mandibular Condyle and Its Actual Application to Orthognathic Surgery: A One-Year Follow-Up Study

Kim

Cheon

et al. 2018

IJERPH

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Background: Favourable occlusal interdigitation and an optimized position of the mandibular condyle after surgery are essential for obtaining favourable results. The position of the condyle is determined during the operation. However, it is difficult to maintain the condyle’s original position post-surgery despite the efforts of the surgeons. Indeed, a degree of rotation of the condyle is unavoidable, since it is difficult to verify whether the condyle is positioned correctly during surgery. Purpose: To maximize contact between the bone segments, the condyle was rotated around the vertical axis using surgical simulations. We examined changes to the condyle-fossa relationship after comparing virtual surgery to actual surgery. Methods: From 2015 to 2017, 20 patients were diagnosed with skeletal malocclusion and participated in computer-aided surgical simulation before undergoing orthognathic surgery. In the simulation, the mandibular condyles were rotated around the vertical axis, and the proximal segments were fixed to the distal segments using a customized miniplate and positioning device during actual surgery. This study investigated the relationship between the condyle and fossa using cone-beam computed tomography for several different time periods (preoperative (T0), virtual surgery (Tv), postoperative three days (T1) and one year (T2)). Results: The coronal and sagittal view exhibited significant differences in the mean values between T1and T0, Tv, and T2 for all joint spaces. As a result of the distance, the mean value of T2 in both the superior joint space (JS) and the lateral JS was significantly higher than that of Tv. In contrast, the mean value of Tv in the medial JS was significantly higher than that of T2. Moreover, the mean value of T2 on the axial plane was significantly larger than the values of Tv and T1. The mean value of T0 was also significantly larger than those of Tv and T1, and the mean value of Tv was larger than that of T1. Although the condyle was rotated, it exhibited a tendency to return to its preoperative position. There was no statistically significant difference in functional evaluation between T0 and T2. Conclusion: Our method of using yaw control for the condyle during virtual surgery and transferring this technique to the actual surgery can improve the conventional surgical technique by positioning the proximal segment in a pre-planned position, thus achieving optimal results.

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Section: Introductionmentioning

confidence: 99%

Computer-Aided Surgical Simulation for Yaw Control of the Mandibular Condyle and Its Actual Application to Orthognathic Surgery: A One-Year Follow-Up Study

Kim

Cheon

et al. 2018

IJERPH

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“…Rubio-Bueno et al (2013) conducted a controlled study for simultaneous augmentation of the upper lip and paranasal area in orthognathic surgery patients. In a preliminary study, Raffaini and Pisani (2015) showed a high patient satisfaction rate for simultaneous soft tissue correction with autologous fat grafting during orthognathic surgery. Also, facial bone contouring techniques are regularly used to improve the appearance after orthognathic surgery (Li et al, 2016; Chen et al, 2017; Qin et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Fat Injection for Nasal Contouring in Orthognathic Patients

Lonic

Hsiao

Huang

et al. 2021

The Cleft Palate Craniofacial Journal

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Background: Augmentation rhinoplasty with autologous fat grafting is a useful procedure to meet the demand for facial harmonization in the Asian population. We used this procedure during orthognathic surgery to address inadequate dorsum projection. This prospective study was conducted to determine the fat retention rate in patients undergoing simultaneous autologous fat injection augmentation rhinoplasty and orthognathic surgery. Methods: Nineteen patients were treated with simultaneous bimaxillary orthognathic surgery and autologous fat grafting of the nasal dorsum and tip. The paired t test was used to compare the nasal volumes before and at least 6 months after surgery measured by 3-dimensional computer tomography scans. All measurements were performed twice by the same evaluator at least 2 weeks apart for intrarater consistency. Results: Seventeen patients completed the study. The volume means before and after surgery were 22.3 ± 4.6 cm3 and 23.3 ± 4.7 cm3, respectively, with a mean difference of 1.0 ± 0.3 cm3 ( P < .001). The mean retention rate was calculated to be 50.5% ± 7.0% (range: 40.5%-64.7%). Intrarater consistency was high with a Cronbach α of .97 ( P < .001) and .98 ( P < .001), respectively. Conclusion: This prospective study provides objective graft retention measurements for fat injection augmentation rhinoplasty combined with orthognathic surgery. All patients were satisfied with the results and no complications or additional morbidity was noted in the postoperative course. We consider this procedure to be a safe, reliable, and powerful adjunct to improve the aesthetic results of orthognathic surgery.

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“…Still, other centers have shown similar results with fat grafting in patients undergoing OS, observing an improvement in the final aesthetic results and patient satisfaction [33,34]. There are also important results reported in the literature on fat grafting in cleft lip repair [35,36]. In care and observation, not every fat graft is the same, and it is necessary to balance the efficiency of time and the effectiveness of the technique [42].…”

Section: Vol 2 Suppl 6 Year 2022mentioning

confidence: 95%

Orthognathic surgery and fat injection for corrective liposculpture: a systematic review

Lucchese¹,

Bisetto²,

Idalgo³

et al. 2022

MedNEXT

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Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from July to September 2022 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library, using scientific articles from 1986 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 32 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its antiinflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.

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Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction

Cited by 28 publications

References 34 publications

Computer-Aided Surgical Simulation for Yaw Control of the Mandibular Condyle and Its Actual Application to Orthognathic Surgery: A One-Year Follow-Up Study

Computer-Aided Surgical Simulation for Yaw Control of the Mandibular Condyle and Its Actual Application to Orthognathic Surgery: A One-Year Follow-Up Study

Simultaneous Fat Injection for Nasal Contouring in Orthognathic Patients

Orthognathic surgery and fat injection for corrective liposculpture: a systematic review

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