In a recently published article in the prestigious scientific journal Medical Research Archives, published by the European Society of Medicine, Dr. Joan Birbe examines how orthognathic surgery can alter nasal structure. He considers both aesthetic and functional effects and proposes strategies to predict and manage these changes in order to improve surgical outcomes.
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 Clínica Birbe in Barcelona and a specialist in oral and maxillofacial surgery, has been published in Medical Research Archives, the scientific journal of the European Society of Medicine (ESMED). The journal brings together healthcare professionals from Europe and around the world to promote research, medical education, and collaboration among specialists from different disciplines.
In his article, Dr. Birbe examines how orthognathic surgery affects nasal morphology, exploring its implications for both aesthetics and function. The study provides valuable insights for healthcare professionals and patients alike.
Advances and Challenges
Dr. Joan Birbe’s study highlights the impact of orthognathic surgery, particularly maxillary procedures, on nasal morphology. Although these surgeries correct dentofacial deformities, they can also produce significant changes in facial aesthetics and respiratory function. The close anatomical relationship between the maxilla and the nose means that any modification to the former can influence the shape and function of the latter. Maxillary movements can lead to several changes that must be considered during surgical planning to avoid undesirable outcomes.
Maxillary advancement increases nasal tip projection and alters the nasal profile. In addition, this procedure may cause widening of the alar base, which can be controlled using alar cinch sutures to help preserve the original shape of the nostrils. Another potential consequence is a reduction in the nasolabial angle, which may result in an excessively upturned appearance of the upper lip. This can be addressed using V-Y closure techniques.
Dr. Birbe also highlights several important functional implications arising from changes to nasal anatomy following orthognathic surgery. While maxillary advancement can improve breathing by increasing airway volume and reducing nasal resistance, particularly in patients with sleep apnea, maxillary impaction may reduce nasal volume and increase resistance.
He also emphasizes the importance of performing rhinoplasty simultaneously with orthognathic surgery, especially in patients with pre-existing nasal deformities. This approach can improve facial aesthetics and help avoid future revision surgery while also addressing functional problems. Simultaneous rhinoplasty is particularly useful in cases of Class III malocclusion, where maxillary advancement alone may not be sufficient to achieve proper facial balance.
The Importance of Technology
Dr. Birbe also emphasizes the importance of technology. Preoperative 3D imaging is essential for managing aesthetic expectations and optimizing surgical outcomes. Furthermore, collaboration between oral and maxillofacial surgeons and rhinoplasty specialists helps ensure better surgical planning, improving both functional and aesthetic results.
According to Dr. Birbe, advances such as cone-beam computed tomography (CBCT) and emerging artificial intelligence-based predictive models make it possible to forecast nasal changes more accurately, thereby improving surgical planning.
In conclusion, Dr. Joan Birbe explains that orthognathic surgery produces predictable yet variable nasal changes that must be carefully anticipated and planned for. Surgical techniques such as alar cinch sutures, V-Y closure, and septoplasty, combined with advanced imaging technologies and collaboration between surgeons and other specialists, can optimize outcomes by improving both facial aesthetics and patients’ respiratory function.
For further details, please refer to the full scientific article (PDF)
Article prepared by the Birbe Editorial Committee.
