Muscle reorientation following superior repositioning of the maxilla.

In facial reconstructive surgery the importance of the orofacial muscles on form, function, and esthetics must be recognized. Once this fact is acknowledged, these muscles may be manipulated to advantage by the surgeon; thus, undesirable effects in the perioral area following superior repositioning of the maxilla can be avoided. A V-Y advancement-closure of the horizontal maxillary vestibular incision is advocated. This successfully repositions the lip muscles in a predictable manner and maintains normal lip form pout, and amount of exposed vermilion. Alar width and unesthetic widening of the alar bases may also be controlled by the proper repositioning of the transverse nasalis muscles. The validity of these surgical procedures is supported by a statistical analysis of the lip and nasal structures in patients whose dentofacial deformities were corrected by superior repositioning of the maxilla and concomitant facial muscle reorientation.