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Tanikawa Plast Aesthet Res 2020;7:48 I http://dx.doi.org/10.20517/2347-9264.2020.136 Page 7 of 16

Figure 4. Verification of the system using a cleft case. Grey profile indicates an average face: (top) pre-surgery; and (bottom) post-
surgery. (left) The standardized X-values of the 3D face when compared with the normative mean (transverse direction). Red, pink,
light yellow, and deep yellow represent the point clouds located outwards when compared with the normative mean; light blue, deep
blue, grey, and black indicate the points located inwards (close to the medial line). Green represents the range within ±1 SD. The left
column indicates the standardized Z-value (transverse direction). Before treatment, the right nasal alar and nasal tip were deviated to
the right side by more than 6 SD. After treatment, the area showing more than 1 SD was decreased; however, the right nasal alar was
still deviated by 6 SD (for the axial view, please see Figure 6). (middle) The standardized Y-value (vertical direction). Red, pink, light
yellow, and deep yellow indicate the corresponding point clouds located inferiorly, whereas light blue, deep blue, grey, and black indicate
the points located superiorly when compared with the normative mean. In this patient, before treatment, the lower lip was located
superiorly by 1 SD, and the chin was located inferiorly by more than 2 SD and showed greater facial height. After treatment, the lower lip
was located within the normal range, indicating that the lower lip had moved downwards after maxillary advancement and mandibular
set-back movement due to the surgery. (right) The standardized Z-value (antero-posterior direction). Red, pink, light yellow, and deep
yellow indicate the corresponding point clouds located anteriorly, whereas light blue, deep blue, grey, and black indicate the points that
were located posteriorly when they were compared to the normative mean. In this patient, before treatment, the nasal dorsum and left
upper lip (repaired cleft site) retruded by more than 1 SD, while the chin protruded by more than 3 SD. After treatment, the chin showed
normal antero-posterior position while the lower lip showed slight retrusion by more than 1 SD. The area of the retrusion in the nasal
dorsum and upper lip was also decreased

Figure 5. Radar chart of the normal area for the example case with unilateral cleft lip and palate [Figure 2]. Surface areas showing -1 SD
< Z-score < 1 SD were defined as the normal area. The percentage of the surface before (red) and after treatment (blue) was evaluated
on: x-axis (left); y-axis (middle); and z-axis (right)

and from 41% to 59% on the z-axis (antero-posterior direction). In detail, the figures for the x-axis show
that before surgery there was greater asymmetry in the cheeks, the nose, nasolabial region, upper lip,