By Harvey M. Rosen M.D., D.M.D (auth.)
Harvey M. Rosen, M.D., D.M.D., broadens the cultured pursuits of maxillofacial surgey during this new, accomplished quantity on orthognathic surgical correction. within the paintings, Dr. Rosen, who has "changed the best way so much surgeons paintings at the jaw and chin," (James Ferraro, President of the Maxillofacial Society), deals his personal own options of jaw surgical procedure. because of the introduction of the biotechnical advances that have stabilized skeletal displacement, Dr. Rosen is ready to emphasize the aesthetics of sentimental facial tissue corrections by way of redefining the targets of aesthetic surgery.
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Additional resources for Aesthetic Perspectives in Jaw Surgery
She was referred for surgical correction of a Class I, anterior open-bite deformity. The patient has a long lower face with a moderate degree of lip strain. The surgical correction involved posterior maxillary impaction, to allow the mandible to autorotate at the condyle to close the open bite, and vertical reduction genioplasty. A total decrease of lower face height of 8 mm was achieved. Postoperatively, there is a stable Class I occlusal result with closure of the 17 18 PAR T 1 PRINCIPLES POSTOPERATIVE PREOPERATIVE A c B D FIG.
In fact, the soft tissues have lost foundational support, which, in turn, results in a loss of facial highlighting, definition, and angularity. Stated differently, one loses the perception of skeletal definition as viewed through the facial mask. This adverse response of the soft tissues to skeletal contraction is not without precedent in the surgical literature. It is frequently seen in the nasal tip and supratip area following reduction rhinoplasty, as critically reviewed by Sheen. Van der Deusen referred to this phenomenon in the face and upper lip following maxillary setback surgery.
B: As the mandible is advanced, it is rotated clockwise to keep the posterior bite from opening. As a result, the chin only comes forward 2 mm despite the incisor teeth advancing 7 mm. The lower face is also lengthened 3 mm. Note also the flaring of the mandibular incisors and steepening of the mandibular plane. C: An osseous genioplasty to advance the chin 6 mm will be necessary to achieve an acceptable result. 36 PAR T 1 PRINCIPLES Occasionally, mandibular advancement surgery may be accompanied by counterclockwise rotation of the mandibular body to close an anterior open bite.