Q: Dr. Eppley, I recently consulted with an orthodontist to improve my smile,I was told that I will need maxillofacial surgery secondary to deficiency in upper jaw/maxilla relative to my bottom jaw/mandible…I have a significant underbite.I am interested in improving my facial appearance,possibly with facial implants,I want to achieve my ultimate “phi”.I am wondering if the upper jaw surgery is necessary and if so should it be done prior to progressing with facial implants or other cosmetic procedures?
A: If you have a significant underbite and you would like that corrected, then you should address that first. Whether a maxillary advancement is a good option depends on numerous factors including one’s age, willingness to participate in a protracted course of orthodontics and how much midface advancement is needed. But if one opts for a maxillary advancement, that should always be done first before considering the placement of facial implants. A maxillary bone advancement should always be done before any effort at facial implant augmentation.
In some cases, facial implants that are custom made can create the identical or better midface result than that of a LeFort I osteotomy as they cover a broader surface area of the midface.
Dr. Barry Eppley