The nasal morphologic changes after LeFort I or II advancement

Objectives: The purpose of this study was to evaluate the changes of the nasomaxillary complex after LeFort I or LeFort II advancement surgery. Methods: Lateral cephalograms of 35 patients (18 LeFort I advancement and 17 LeFort II advancement) who underwent maxillary advancement with mandibular setback were evaluated. Results: The results showed that in LeFort I advancement group, the changes of the nose were limited to the nasal tip area. The nasal dorsum became more concave mainly due to the superoanterior rotation of the nasal tip. In LeFort II advancement group, the total nasomaxillary complex was significantly advanced anteriorly except N'. N' moved superiorly more than anteriorly. Thus the total nasal height was increased mainly due to the increase of the upper nasal height. The increase of the columellar angle and nasal projection angle was minimal. Conclusion: This study suggests that while the changes after LeFort I advancement are esthetic for those patients with some nasal tip depression and/or nasal hump preoperatively, the procedure may produce a smaller looking nose and increase the amount of nostril show postoperatively due to superoanterior rotation of the nasal tip. In the other hand, LeFort II advancement was considered as an effective procedure to advance the nasomaxillary complex with minimal change of the nasal shape.