Q: Dr. Eppley, I’m currently in the midst of orthodontic treatment and I’m scheduled for some surgical palatal expansion and double jaw surgery later on (Lefort I). I have recessed maxilla and mandible bones, so they will both be advanced (after my palatal expansion is complete).
I also have a midface deficiency. I have a tear trough deformity and scleral show. I believe that a LeFort III would work for me, but I have to be realistic because it’s very invasive. I don’t suppose I’ll be able to find a surgeon to perform such an invasive operation on me – which is why I would like to ask if a malar osteotomy and some kind of orbital rim procedure after my jaw surgery would produce the same results as a Lefort III – filling out my midface, making my cheekbones more prominent, and correcting scleral show. Do you offer those procedures?
A: There is no question that a simpler and more effective treatment to your upper midface concerns is NOT a LeFort III but custom orbito-malar facial implants. They would provide a much better result than trying to move the bone and are made from a 3D CT scan and could be done after your orthognathic surgery.
Dr. Barry Eppley