Complementing Orthognathic Surgery Esthetic Outcomes With Facial Prosthesis

Orthognathic surgery is commonly performed to correct skeletal malocclusions, with facial esthetics increasingly recognized as a key motivator for treatment acceptance. In certain cases, conventional orthognathic techniques may not fully address midface and lower facial contouring demands, requiring adjunctive approaches such as alloplastic augmentation. This case report describes a 58-year-old female patient presenting with a chief complaint of midface and lower third facial deficiency. Clinical evaluation revealed anteroposterior and vertical mandibular hypoplasia with class II malocclusion. After preoperative orthodontic alignment, the patient underwent monomaxillary Le Fort I osteotomy combined with a custom-made mandibular PMMA implant extending from angle to chin, as well as a liplift procedure. The surgical technique was performed via an intraoral approach under general anesthesia, with successful implant placement and no intraoperative complications. Postoperative recovery included adjunctive therapies such as laser application and physiotherapy. At 1-year follow-up, the patient demonstrated excellent healing, with no signs of infection or implant-related complications and showed significant improvement in facial balance and harmony. Customized alloplastic implants represent a safe and effective solution to refine esthetic outcomes in orthognathic patients, especially in cases of volume deficiency. Literature supports their biocompatibility, low complication rates, and high patient satisfaction when used as adjuncts to skeletal procedures. Custom-made mandibular implants may serve as valuable adjuncts in orthognathic surgery, offering predictable esthetic enhancement and long-term stability.