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Correction of midface hypoplasia using a novel trapezoidal osteotomy

Wenyang Li, Ashish Khadka, Jing Hu, Dazhang Wang, Qiushi Wang, Jihua Li
Journal of Craniofacial Surgery 2012, 23 (3): 869-71

BACKGROUND: Currently, investigating an optimal method to deal with midface hypoplasia has become a significant issue in the field of facial aesthetic surgery. Traditional ways to address this problem primarily include segmental osteotomies and using autogenous bone or cartilage grafts or synthetic implants. For the patients with paranasal hypoplasia but without malocclusion, autogenous bone grafts or implants are recommended. However, some of these patients have a flattened nose and protrusive malar, especially in the Eastern Asian; the nose will seem more flattened after augmentation the paranasal area. Hence, osteotomy is necessary in these patients to bring the flattened nose forward to get a more satisfying contour of the midface.

METHODS: We propose a novel osteotomy through the application of model surgery to solve the problem of midface hypoplasia combined with flattened nose but without malocclusion. When compared with other techniques, this novel method not only allows the augmentation to be performed on a broader scale composed of different segments of the midface skeleton, but also results in a lower surgical risk and maintenance of the stability of occlusion.

RESULTS: This novel osteotomy can bring the premaxilla in combination with the nasal bone forward to solve the problem of midface hypoplasia combined with flattened nose in patients with normal occlusion.

CONCLUSIONS: Through simultaneous augmentation of the different segments of the midface through this novel osteotomy, a more pleasing contour of the midface in all 3 dimensions can be achieved.

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