Postoperative swelling after orthognathic surgery: a prospective volumetric analysis.

PURPOSE

Three-dimensional (3D) stereophotogrammetry is a reliable, accurate, and noninvasive tool for measuring changes in soft tissue volume over time. The purpose of this prospective study was to quantify changes in postoperative swelling after orthognathic surgery using serial 3D photographs.

PATIENTS AND METHODS

Three-dimensional photographs of 49 orthognathic surgery patients (Le Fort I and/or bilateral sagittal split osteotomy) were captured using the 3D Vectra imaging system pre-operatively (T0) and at one week (T1), two weeks (T2), three weeks (T3), four weeks (T4), six weeks (T5), three months (T6), six months (T7) and one year (T8) postoperatively. Canfield Mirror imaging software was used to quantify volume differences between serial 3D images. Descriptive statistics and repeated measures analysis of variance were calculated. Data were stratified by gender, preoperative body mass index (BMI), and procedure performed.

RESULTS

On average, 50% of the initial swelling resolved after the third postoperative week (T3), and, after 3 months (T6), only 20% of the initial edema remained. Patients with a higher BMI had the greatest amount of swelling and fastest rate of resolution in the initial weeks after the operation. Patients with a lower BMI had less postoperative edema and a slower rate of reduction between all time points. Initial swelling and resolution did not vary significantly by gender or type of malocclusion.

CONCLUSIONS

Facial edema resolves rapidly during the first three post-operative weeks; significant decrease in soft tissue swelling still occurs between 6-12 months post-operatively.