Early soft tissue changes in the nasolabial angle following maxillary advancement: a comparison of two surgical methods.

Le Fort I osteotomy is a common orthognathic surgery procedure, but can result in unpredictable nasolabial changes, highlighting the need for a greater understanding of its effects on the soft tissue and evaluation of alternative techniques. The aim of this study was to compare the subspinal Le Fort I osteotomy (SSLFI) to conventional Le Fort I osteotomy (cLFI) regarding their impact on the nasolabial angle (NLA), with the goal of clarifying their clinical implications and assessing the utility of the subspinal approach. This retrospective analysis included 38 patients who underwent maxillary advancement between 2010 and 2023, using either the cLFI or SSLFI. Soft tissue changes were evaluated at a minimum of six months postoperatively, corresponding to the early healing phase when some residual swelling may persist. The mean maxillary advancement was 6.16 mm in the cLFI group and 6.37 mm in the SSLFI group. NLA tended to decrease in the cLFI group and increase in the SSLFI group, with the most pronounced differences observed when advancement exceeded 5 mm. Sex had no effect on NLA change. These findings underscore the importance of careful surgical planning and patient counseling, while recognizing that soft tissue adaptations may continue beyond the early postoperative period.