Skip to main content

Advertisement

SpringerLink
Log in

Mid-facial soft tissue re-suspension following skeletal fixation after maxillofacial trauma—a prospective case series study

  • Original Article
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Purpose

Open reduction and internal fixation (ORIF) is used for reduction and stabilization of facial fractures. Despite perfect anatomic skeletal reduction, subtle asymmetries are seen in facial appearance as mid-facial soft tissue often reattaches to the respective facial bones in an aberrant, mostly lower in position. Thus, the present study evaluates the effectiveness of mid-facial soft tissue re-suspension procedure to prevent changes in mid-facial soft tissue profile after ORIF of maxillo-facial fractures.

Methods

Fifteen patients with maxillo-facial fractures requiring ORIF were included. After ORIF, mid-facial soft tissue resuspension (STRP) was done by suspending the soft tissue and periosteum over cheek region from temporal fascia by polydioxanone suture material. The results were analyzed by patient satisfaction survey and doctor perspective form on photographs by three surgeons 6 months postoperatively.

Results

All patients were male in the age range of 18–60 years. STRP was done unilaterally in 7 cases and bilaterally in 8 cases, with average time ranging from 10.6 to 20.5 min. The patient satisfaction survey revealed that 86.6% were pleased with their appearance and 93% said that there was no abnormal change in the esthetics postoperatively. The doctor perception form revealed almost 80% agreement, that there was minimal change in the appearance of cheek mound, nasolabial fold, corner of the mouth, and lateral canthus postoperatively.

Conclusion

STRP is a simple technique to perform with fewer complications, and helps in restoring facial esthetics, same as prior to facial trauma; as it prevents soft tissue sagging after degloving incisions for fracture reduction and fixation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

taken from the temporal fascia of both the suture ends; knot tied between two ends of suture material after ensuring adequate required pull of resuspended midfacial tissues (b)

Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Vincent RL, Shepherd JP (1994) Maxillofacial injuries, 2nd edn. Churchill Livingstone, p 1053

  2. Salin MB, Smith BM (2005) Diagnosis and treatment of midface fractures. Fonseca, Oral and maxillofacial trauma, volume 2, 3rd edn, p 644

  3. Doerr TD, Mathog RH (2001) Le fort fractures (Maxillary Fractures). Facial plastic and reconstructive surgery, 3rd edn, p 991

  4. Yaremchuk MJ, Kim WK (1992) Soft-tissue alterations associated with acute, extended open reduction and internal fixation or orbital fractures. J Craniofac Surg 3(3):137

    Article  Google Scholar 

  5. Edward Ellis III (2005) Advances in maxillofacial trauma surgery. Fonseca, Oral and maxillofacial trauma, volume 1, 3rd edn, p 365

  6. Stewart MG (2000) Head, face and neck trauma: comprehensive management, p 148

  7. Louis PJ (2004) Management of Panfacial Fractures. Michael Miloro, Peterson’s principles of oral and maxillofacial surgery. Second Edition, Volume 1, 2004, Chapter 28; p 551–2

  8. Flynn John (2005) Suture suspension lifts: a review. Oral Maxillofac Surg Clin N Am 17(1):65–76 (vi)

    Article  Google Scholar 

  9. Niamtu J 3rd, Chisholm B (2004) The adjustable vector deep plane midface lift. J Oral Maxillofac Surg 62(5):630–7

    Article  PubMed  Google Scholar 

  10. Baker NJ, Evans BT, Lang DA, Ayliffe P, Booth PW, Downie IP (2007) Management of craniofacial, nasoethmoid, and grossly comminuted midface fractures. In: Booth PW, Schendel S, Hausamen JE (eds) Maxillofacial Surgery. 2nd edn, Volume 1, p 197

  11. McMahon JD, Koppel DA, Devlin M, Moos KF (2005) Maxillary and panfacial fractures. In: Booth PW, Eppley B, Schmelzeisen R (eds) Maxillofacial trauma and esthetic facial reconstruction, p 255

  12. Ellis E III (2005) Fractures of the zygomatic complex and Arch. Fonseca, Oral and maxillofacial trauma, Volume 1, 3rd edn, p 593

  13. Peacock ZS, Bast BT (2012) LeFort fractures. Current therapy in oral and maxillofacial surgery. In: Bagheri SC, Bell RB, Khan HA (eds) p 337

  14. Herford AS (2012) Pan-facial trauma. Current therapy in oral and maxillofacial surgery. In: Bagheri SC, Bell RB, Khan HA (eds) p 359

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, KLEVK Institute of Dental Sciences and Hospital, KLE Academy of Higher Education and Research, Belgaum, 590010, Karnataka, India

    Abhinav Bhatnagar & Sanjay S. Rao

Authors
  1. Abhinav Bhatnagar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanjay S. Rao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanjay S. Rao.

Ethics declarations

Ethics approval

The study has been approved by the IEC KLE VK Institute of Dental Sciences.

Consent to participate

The patients included in the study have consented for participation and publication of the findings. Informed consent was obtained from all individual participants included in the study.

Consent for publication

The patients included in the study have consented for participation and publication of the findings.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bhatnagar, A., Rao, S.S. Mid-facial soft tissue re-suspension following skeletal fixation after maxillofacial trauma—a prospective case series study. Oral Maxillofac Surg 27, 445–457 (2023). https://doi.org/10.1007/s10006-022-01083-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-022-01083-w

Keywords

Search

Navigation