Am I Too Old For A LeFort Osteotomy?
Q: Dr. Eppley, I am 49 years old and am interested in the LeFort 1 procedure. Please see attached photos and give me your advise, I had brace work done twenty years ago because my top teeth were behind my lower front teeth. I think a LeFort 1 procedure would have been more appropriate. Can it be done now? Please advise me as to what surgery would give me a more attractive face.
A: Thank you for sending your photos. What they demonstrate is that you have a midfacial hypoplasia and you are correct in that a LeFort I advancement done years ago would have been better for facial balance and midfacial fullness. But doing it now is not possible because it will change the way your teeth meet. This is why LeFort surgery and orthognathic surgery in general is done in conjunction with orthodontics. I have done them in patients your age and older but only if they were edentulous and wore dentures as new dentures are relatively easy to make.
What you can do now is camouflage your midfacial hypoplasia with paranasal/premaxillary facial implants to bring the base of the nose and the central maxilla more forward. This can be demonstrated with computer imaging.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.