The effects of nasal changes on profile aesthetics after le fort 1 osteotomy: evaluation of the correlation between cephalometric nasal changes and patient's perception

Aim: The purpose of this study is to evaluate the correlation between cephalometric measurements and patient perception of nasal changes in Class III patients who underwent Le Fort I osteotomy. Subjects and Method: Eighty-five patients were included in this study who underwent orthognathic surgery with maxillary impaction and/or only maxillary advancement. Lateral cephalometric radiographs taken before and at the end of the treatment were analyzed with Dolphin Imaging Software. Sixteen parameters related to the nose were evaluated including 10 angular, 5 linear and 1 proportional measurement. The patients were given an aesthetic evaluation form and asked to evaluate their noses on the Likert scale, while at the same time they were asked to evaluate their profile silhouettes without knowing that it was theirs own. The correlation and differences between the cephalometric measurements and the scores obtained from the aesthetic perception questionnaire were evaluated. Results: Postoperative nasal tip inclination and rotation, nasofacial angle and sagittal movement of pronasale (Prn-VR) increased statistically significantly; nasal tip protrusion, nasofrontal angle and vertical movement of pronasale (Prn-HR) values decreased (p<0,05). The nasolabial angle, nasal tip rotation and Prn-HR distance between pre- and postoperative period showed a significant difference between the two surgical groups (p <0,05). At the end of the treatment, significant increase was observed in the patients' objective nasal aesthetic scores (p<0,05). According to the results of the questionnaire, no significant difference between subjective and objective postoperative nasal aesthetic perception were observed. Conclusion: There was moderate correlation between patients' perception of nasal changes and cephalometric measurements after orthognatic surgery. Nasal region soft tissues are affected by the vertical and sagittal surgical movements of the maxilla. The changes in nasal soft tissues after surgery differ according to the type of maxillary movement and these nasal changes are found mostly pleasing by the patients.