Nasal considerations in orthognathic surgery.

The functional correction of dentofacial deformities by orthognathic surgery produces major changes in facial appearance. Facial esthetics must therefore be equally appreciated by the orthodontist and the maxillofacial surgeon. The orthodontist must perform a thorough esthetic facial evaluation along with his usual orthodontic evaluation. The treatment plan must then be based on the esthetic evaluation and knowledge of the facial changes caused by orthodontic treatment and skeletal jaw surgery. Central to facial form is the nose. This article will outline the proper functional and esthetic evaluation of the nose in relation to the face. Nasal and upper lip changes associated with maxillary procedures will also be covered in detail. In light of these two areas, proper treatment planning and sequencing will be discussed.