One-stage approach to the correction of facial skeletal deformity with malocclusion

A total of 40 patients with varying degrees of facial skeletal deformity an d Class III malocclusion were treated by bimaxillary osteotomy combining ma xillo-malar augmentation and/or osseous genioplasty at the same sitting by the author. In all patients, the maxillary advancement and mandibular set b ack were performed, using Le Fort I maxillary osteotomy and bilateral sagit tal split osteotomy of the mandibular rami. In additional bimaxillary osteo tomy, simultaneous maxillo-malar augmentation and genioplasty in 20 patient s, genioplasty in 12 patients, maxillo-malar augmentation in eight patients , were performed to improve facial harmony. All patients were followed clin ically and radiographically for at least 1 year and as much as 5 years afte r undergoing surgical correction. No cases with relapse or other major comp lications have been encountered up to now. There were, however, persisting unilateral inferior alveolar nerve damage in two patients, prolonged nerve anesthesia or hypoesthesia in four patients, and short period anesthesia or hypoesthesia in 11 patients, wide alar base in three patients and slight d eviation of cartilage septum in two patients. There were no other complicat ions encountered and an unexpected result. The facial skeletal deformity an d malocclusion were always treated satisfactorily as patient and plastic su rgeon's expectations in one-stage operation, without significant complicati ons and morbiditiy.