Frontal soft tissue morphology with double V-Y closure following le fort I osteotomy

This prospective study compares the nasal and maxillary vermilion morphology in three groups of patients who underwent maxillary osteotomies and whose soft tissues were managed by different surgical techniques. Eleven of these patients had simple primary closure (SPC) of the maxillary circumvestibular incision; ten were treated with single V-Y closure (SVY) combined with nasolabial muscle reconstruction, and the remaining 11 were treated with a double V-Y closure (DVY) combined with nasolabial muscle reconstruction. All three groups showed significant increases in the alar dome width. Further inspection of the data revealed that the DVY group showed significant, strong correlations between the preoperative and postoperative vertical vermilion measurements. Although the SVY and SPC techniques showed significant correlations for the same measurements, their correlation values were less. Small significant decreases averaging from 0.5 mm to 1.0 mm were seen in all but one of the vertical vermilion measurements with the DVY technique. Larger individual decreases and increases were seen with the SVY and SPC techniques. These findings suggest a level of predictability in the postoperative vermilion height change with the DVY closure that is not obtainable with the SVY or SPC techniques.