Abstract
Surgery first is an option in orthognathic surgery that meets the demands of patients with dentofacial deformity looking for an expedited solution to their esthetic concerns. These cosmetically driven patients are also looking to maximize facial esthetics with the surgical procedures. Ancillary surgical procedures such as implants in the malar region, mandibular angle region, and chin are some of the options to enhance the surgical result. Fat grafting and submental lipectomy are also minimally invasive procedures that can add volume in certain areas of the face and reduce in others such as the submental region to achieve better facial contours. Rhinoplasty also is a major cosmetic adjunct to orthognathic surgery that often is done in an asynchronous manner to enhance facial esthetics. In some instances, rhinoplasty is required to correct the undesired soft tissue effects in the nasomaxillary complex with orthognathic surgery.
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