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This study retrospectively assessed pre- and postoperative three-dimensional (3D) surface models (SMs) to evaluate nasal soft-tissue changes associated with clockwise (CW) and counterclockwise (CCW) Le Fort I movements combined with bilateral sagittal split osteotomy (BSSO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-six patients (23 CW, 33 CCW) who underwent Le Fort I osteotomy with BSSO between January 2016 and February 2020 were included. 3D SMs were obtained 1\u00a0day preoperatively and 6 weeks postoperatively using the Vectra M5 stereophotogrammetry system (Canfield Scientific, USA). Seventeen anthropometric nasal parameters were measured with OnyxCeph3 (Image Instruments, Germany).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the overall cohort, 8 of 17 nasal parameters showed significant postoperative changes. Most notably, transverse nasal dimensions increased, while nasal height and nasal dorsum length decreased. Subgroup analyses revealed that, after Holm\u2013Bonferroni adjustment, 2 parameters remained significant in the CW group and 6 in the CCW group. However, direct between-group comparisons revealed no significant differences in the magnitude of postoperative changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Le Fort I osteotomy combined with BSSO consistently alters nasal morphology, particularly by widening the alar and subalare regions and reducing nasal height. While both CW and CCW rotations produced measurable anthropometric changes, direct between-group comparisons showed no significant differences in the magnitude of postoperative changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10006-026-01621-w","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T01:31:48Z","timestamp":1787103108000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of clockwise and counterclockwise Le Fort I movements combined with bilateral sagittal split osteotomy on nasal morphology"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-1159","authenticated-orcid":false,"given":"Robin","family":"Hartmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Schoebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Obermeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Geyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Geyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenko","family":"Smolka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waltraud","family":"Waiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Ettl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"1621_CR1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1055\/s-0033-1357109","volume":"27","author":"D Khechoyan","year":"2013","unstructured":"Khechoyan D (2013) Orthognathic Surgery: General Considerations. 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All procedures performed in this study were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individuals included in the study.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We hereby affirm that informed consent has been obtained from the patient(s) for the use of their photographs in our manuscript. This consent encompasses all forms of media, including print, digital, and electronic formats, as part of the publication process. The patient(s) have been thoroughly informed about the nature of the publication, the context in which the photographs will be used, and the potential audience. They have been reassured that their anonymity will be preserved and that no personal or identifiable information will be disclosed. The consent was obtained in a manner that adheres to ethical standards and respects the rights and dignity of the patient(s).","order":3,"name":"Ethics","label":"Consent to Publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Consent to Participate was obtained from all individuals included in the study.","order":4,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"DRKS (German Clinical Trials Register), DRKS00037763 (Registration Date: 25.08.2025).","order":5,"name":"Ethics","label":"<b>Clinical trial registration number<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"135"}}