Cosmetic procedures in orthognathic surgery

Purpose: Orthognathic surgery produces cosmetic and functional effects, and patients should be evaluatedfor additional cosmetic improvements beyond those possible with orthognathic surgery. Soft tissue procedurescan be performed on an outpatient basis in an office environment and can be combined withorthognathics and delayed in a second stage.Methods: Systematic accurate facial evaluation is necessary to focus on cosmetic soft tissue problems.Features that make the patient look unattractive, old, tired, out of shape, weak, or sad must be identified byaccurate clinical analysis and 3-dimensional planning. Then it will be possible to select the treatment planaccording to the patient’s input, prioritizing the additional cosmetic improvements that can be added toprimary surgery.Results: It is particularly important to review the results and the patient’s satisfaction by clinical examination,a questionnaire, and with 3-dimenisonal pictures, and to understand if the treatment options have beenaccurately chosen and their lasting effect on follow-up. The treatment sequence is analyzed, and if there areresidual defects, a secondary cosmetic procedure can be planned to complete the result.Conclusions: The surgeon’s goal must be the simultaneous treatment of malocclusions and facial estheticdisharmonies, and orthognathic surgical procedures and facial cosmetics must be performed simultaneously,if possible. Residual defects must be treated after at least 6 to 12 months.