In an article recently published in the prestigious scientific journal Medical Research Archives of the European Society of Medicine, Dr Joan Birbe discusses how orthognathic surgery can modify nasal structure. He considers both aesthetic and functional effects and proposes strategies to predict and control these changes in order to improve the results of the intervention.
Functional and aesthetic implications
The study The Impact of Orthognathic Surgery on Nasal Morphology: A Systematic Review by Dr. Joan Birbe, founder and Medical Director of the American College of Orthognathic Surgeons. Joan Birbe, founder and Medical Director of Clínica Birbe in Barcelona, and specialist in maxillofacial and oral surgery, has been published in Medical Research Archives, the scientific journal of the European Society of Medicine (ESMED), which brings together health professionals from Europe and internationally in order to promote research, medical education and collaboration between specialists from different disciplines.
In his article, he discusses how orthognathic surgery affects nasal morphology, exploring its implications for aesthetics and functionality. The study provides valuable information for practitioners and patients.
Advances and challenges
Dr Joan Birbe’s study highlights the impact of orthognathic surgery, particularly interventions on the maxilla, on nasal morphology. Although these surgeries correct dentofacial deformities, they also generate significant changes in facial aesthetics and respiratory function. The close relationship between the jaw and the nose means that any modification of the jaw influences nasal form and function. Movements of the jaw result in several aspects that need to be taken into account during surgical planning to avoid undesirable effects.
Maxillary advancement increases nasal tip projection and modifies the profile. In addition, this surgery may cause widening of the alar base, which can be controlled with alar cinch sutures to maintain the original shape of the nostrils. Another consequence is that the nasolabial angle tends to decrease, which may result in an excessively rotated upper lip appearance, something that is corrected with V-Y closure techniques.
Dr Birbe also highlights some important functional implications of altering nasal anatomy with orthognathic surgery. While he notes that maxillary advancement can improve breathing by increasing airway volume and reducing nasal resistance, especially in patients with sleep apnoea, it is possible that maxillary impaction decreases nasal volume and increases resistance.
He also stresses the importance of simultaneous rhinoplasty in orthognathic surgery, especially in patients with previous nasal deformities. This technique improves facial aesthetics and avoids future revisions, while at the same time correcting functional problems. Simultaneous rhinoplasty is particularly useful in cases of Class III malocclusion, where maxillary advancement alone is not sufficient to achieve adequate facial balance.
The importance of technology
He also emphasises the importance of technology. The use of preoperative 3D imaging is essential to manage aesthetic expectations and optimise outcomes. In addition, collaboration between maxillofacial surgeons and rhinoplasty specialists ensures better surgical planning, improving both functional and aesthetic outcomes. According to Dr Birbe, advances such as CBCT scans and recent artificial intelligence-based predictive models allow for more accurate prediction of nasal changes, which improves surgical planning.
In conclusion, Dr Joan Birbe argues that orthognathic surgery causes predictable but variable nasal changes that must be carefully planned. Surgical techniques such as alar cinch sutures, V-Y closure and septoplasty, together with the use of advanced imaging technologies and collaboration between surgeons and various specialists, optimise the results, improving both aesthetics and the patient’s respiratory function.
For more details, the full articlecan be found at this link: DOI.
Article written by the Birbe Editorial Board
