Post-Traumatic Facial Asymmetries: Challenges in Three-Dimensional Diagnosis and Surgical Correction Strategies

Abstract

Post-traumatic facial asymmetries represent a relevant clinical challenge due to the anatomical complexity involved and the limitations of conventional diagnostic methods. With the advancement of three-dimensional technologies such as cone-beam computed tomography (CBCT), surgical simulation software, and personalized 3D-printed guides, it has become possible to perform more precise morphological evaluations, contributing to more efficient surgical planning. Recent studies demonstrate that the use of virtual planning and customized devices significantly improves accuracy in correcting asymmetries, especially in cases involving the lower third of the face, mandibular angle, and chin deviations. Furthermore, soft tissue–driven approaches have been integrated into bone planning, allowing for superior aesthetic predictability. Techniques such as guided osteotomy, use of patient-specific implants (PSIs), and planning assisted by artificial intelligence have been successfully described in the correction of residual and postoperative deformities. The literature emphasizes the importance of accurate diagnosis based on digital symmetry and volumetric analysis, highlighting the need for individualized therapeutic strategies. Thus, the integration of three-dimensional tools and detailed surgical planning represents an evolution in the management of patients with post-traumatic facial asymmetry, providing better functional and aesthetic outcomes.