How Can Improve My Flat Face After A LeFort I Osteotomy?

Q:  I had a Le Fort I osteotomy to correct my bite, which it did. Despite the upper jaw movement my midface still appears flat. I was told to look toward having cheek and paranasal implants to correct my profile.

A: A LeFort osteotomy only affects the face at the upper jaw/upper tooth level, otherwise known as the maxilla. If the maxilla is brought forward (LeFort advancement) it can change the anterior nasal spine and the base of the nose, opening up the nasolabial angle and providing some paranasal augmentation. But it takes a significant movement forward to make those changes. But it will never provide any cheek or zygomatic enhancement as the level of the bone movement is way below these bone structures.

Secondary midface augmentation will require cheek and paranasal implants to achieve increased midface fullness/projection. When the degree of midfacial fullness is recognized before the LeFort procedure, the implants can be placed at the same time. But they can also be done afterwards as a secondary procedure. This would also provide an opportunity to remove the metal plates and screws that were initially placed to hold and heal the LeFort osteotomy. Four implants are used to create both lower (paranasal) and upper (cheek) midfacial augmentation.

Dr. Barry Eppley

Indianapolis, Indiana