Q: Dr. Eppley, I am interested in midface shortening. I am interested in the LeFort 1 procedure. However I do not have a gummy smile, so would that be an issue? Perhaps there are better ways to solve the midface ratio by playing around with facial/jaw width. Is there a way to send pictures and get a professional opinion?
A: You are correct in that doing a LeFort I impaction without a gummy smile will have adverse effects on the upper lip-tooth relationship and is not a good idea. Burying the upper teeth under the upper lip has a negative facial effect and creates more of an aging appearance. Searching for other facial options would be what needs to be explored. Please send me some pictures of your face for my assessment and computer imaging of other potential facial reshaping options. Rhinoplasty, midface and/or jaw augmentation and lip enhancements can all be potential facial reshaping procedures that can change the disproportionate appearance of a long or strong middle third of the face.
True midface shortening can only be done through a LeFort 1 impaction as a vertical shortening of a bony vertical maxillary excess.
Dr. Barry Eppley