Can Midface Shortening Be Achieved By A LeFort I Impaction Surgery?
Q: Dr. Eppley, I want to shorten my midface to bring it into better facial balance. I think a LeFort I impaction osteotomy will work, what do you think? I have attached another surgeon’s result from a similar procedure which is why I ask.
A: Thank you for your inquiry and sending your picture. In answer to your midface shortening question:
No matter what you do to the midface bone in terms of bone shortening or rotation the external midface is not going to get look shorter which I assume is your goal. Everyone forgets about the soft tissue part of the midface which can not be removed or tightened unlike the upper and lower facial thirds. Midface augmentation techniques that improve its projection will help with the illusion that it is shorter..which is done by different forms of maxillary-infraorbital-cheek implants. Otherwise I would ignore that before and after LeFort1 osteotomy example as that is a very misleading result because it is early postop, is deliberately tilted downward and the patient has had a rhinoplasty that has rotated the tip upward. All of this makes it looks like the LeFort osteotomy has shortened the midface when in fact it has not.
Dr. Barry Eppley