LeFort 1 Osteotomy

Q: Dr. Eppley, For purely cosmetic reasons, I wanted to know if it was possible to lengthen my midface by performing a 1-2mm dual sided vertical ramus distraction of the mandible? Also a 1-2mm LeFort 1 osteotomy vertical elongation similar to the fashion of that provided in the attached photo that had featured the osteotomy and bone grafts. And if so, what would be the likely maximum cost after taxes and hospital bills?

A: What you are  seeking is vertical elongation of the maxillomandibular complex. If all that is needed is a few millimeters of vertical lengthening of the maxilla and mandible, there would be no reason to undergo any form of distraction. This can be done by using conventional orthognathic surgery operations such as a LeFort 1 osteotomy with interpositional bone grafting and a sagittal split osteotomy of the mandible. I would not do a LeFort 2 osteotomy as this is associated with an incraesed difficult factor that requires a coronal scalp incision to complete. Whatever aesthetic benefits that may come from a LeFort 1 osteotomy vs a LeFort 2 osteotomy, the added surgical risks and effort are not worth it. Such bimaxillary orthognathic surgery will cost in the range of $40,000 to $50,000 to undergo.

Dr. Barry Eppley

Indianapolis, Indiana