Q: Dr. Eppley, Since you’re a maxillofacial surgeon, you know about the LeFort III Osteotomy that is done in cases of severe midfacial hypoplasia where the patient usually suffers from a syndrome like Crouzon’s.
However, many say that such a procedure,although extremely invasive and dangerous in some cases, could theoretically improve the appearance of a non-deformed patient dramatically.
Since almost no maxillofacial surgeons would perform this osteotomy on patients that have no bite or jaw problems, are there any cosmetic operations that can be done on a non-syndrome patient and replicate the aesthetic outcomes of a Lefort III osteotomy?
A: The effects of a LeFort III osteotomy are to bring forth the lower orbital rim, nose bridge and base and maxilla. This type of change can be replicated by a custom only implant placed over the exact same facial areas. While previously not possible, the use of custom implant design from a 3D CT scan make possible a midface implant that can essentially replicate what a LeFort III osteotomy can do. (minus the occlusal changes) I have made several of these midface implant designs recently and they are inserted through an intraoral incisional approach. Only the augmentation of the nose needs to be done separately through a closed rhinoplasty approach.
Dr. Barry Eppley