Am I A Good Candidate For A LeFort II Osteotomy?

Q: Dr. Eppley, Please allow me to provide the context and reasoning for my case. I have a slightly recessed midface but a prognathic upper and lower jaw (SNA angle of 102 degrees), and because of this my upper midface looks significantly recessed compared to my lower third. I would like a cosmetic correction to this issue, but there’s a problem – I don’t believe I can get custom midface implants on their own because my nasion is also recessed and my nasal projection is therefore not sufficient to accommodate midface implants – I would have a sunken/flattened appearance of the nose. In my opinion, trading one disharmony for another is bad practice. Given this state of affairs, am I correct in believing that a Lefort 2 coupled with custom midface implants would be (at least theoretically) the only way to resolve my aesthetic issues without creating new ones? While I understand that this surgery is invasive and not typically offered for cosmetic reasons only, I believe my anatomical situation is somewhat unique and warrants the consideration of this type of operation. What’s your take?

A: A LeFort II osteotomy would seem like a very invasive approach to correcting a recessed nasion, which is the primary reason you are considering it, when a nasal implant or cartilage graft would achieve the same effect.

Dr. Barry Eppley

World-Renowned Plastic Surgeon