What Type Of LeFort Osteotomy Is Needed To Fix Nasomaxillary Hypoplasia?
Q: Dr. Eppley, I’m fairly sure I have nasomaxillary hypoplasia (not to be confused with Couzon’s Syndrome-tier midfacial hypoplasia). The whole area around my nose (zygomas, maxilla, infraorbitals) is recessed and this not only puts me at a great aesthetic disadvantage but also causes me severe obstructive sleep apnea that’s refractory to traditional treatments (mouthpiece, CPAP machine, weightloss – I’m not currently obese).
As such, I need a Lefort 2 Osteotomy.
My question to you is: In an effort to minimize the risk of death during the surgery (if I recall correctly, the LF2 osteotomy is supposed to have a 10% mortality rate but I might be confusing it with the LF3 osteotomy), is it surgically possible to completely leave out the nasal bones and only move forward and/or lift the remaining portion of the midface, ie.: zygomas, infraorbitals and maxilla?
Below, I’m attaching the relevant picture(s) of my face showcasing my nasomaxillary hypoplasia. (the text says: the maxilla, the zygomas and the infraorbital bones are severely recessed. the philtrum appears to be long and flat)
Thank you in advance!
A: I am not aware of any risk of death from any form of Lefort osteotomies regardless of the level at which it is done.
What you are describing is what is commonly known as a modified LeFort III osteotomy.
Dr. Barry Eppley