Q: Dr. Eppley, Is it possible to shorten the midface? Is there a surgery for midface shortening? If so how much can be done? I don’t have a gummy smile, just a long distance from my eyes to my mouth. I plan on getting jaw advancement to lengthen my lower face, but I still think the midface would be out of proportion. Would a rhinoplasty and lip lift help? I don’t have any pictures, but I hope you may give me a general idea as a plastic surgeon. I understand I would still have to see one in person eventually.
A: There is a midface shortening surgery that is based on vertically shortening the length of the maxilla. This is known as a Lefort 1 impaction procedure that is used in the gummy smile patient to treat vertical maxillary excess. This does not appear to apply to you. Other than this skeletally based procedure, only a camouflage approach may provide some benefit. Procedures such as a rhinoplasty and a lip lift can be of some benefit to create a midface shortening effect depending on the shape of the nose and the length of the pper lip.
Dr. Barry Eppley