Will A LeFort 1 Osteotomy Adequately Address My MIdface (Cheeks and Nose) Deficiency?

Q: Dr. Eppley, I’m wondering if you could be so kind as to help provide me with an opinion as to one aspect of my surgery.

My surgeon is proposing a standard Lefort 1 movement of my maxilla. However, I’m not convinced this will adequately address what I perceive as the deficiency in my midface (cheeks/nose).

Does you have a view on this and what the other options might be? I appreciate it may be difficult to say for certain based only on photographs

Thank you for your help. I’m just looking to get as much info as possible at this stage.

Kind regards,

A: As a general statement a LeFort I osteotomy moves the lower third of the midface that contains the alveolar bone and teeth. While there can be some midface aesthetic benefits with forward movement, they are going to be limited to the base of the nose and upper lip. How significant those effects would be depends on the amount of horizontal movement. But anything less than 5mms will have a negligible effect in that regard. In short most LeFort I osteotomies are done as a functional operation that corrects malocclusions. (minus bimaxillary osteotomies for sleep apnea) They can have some limited aesthetic benefits with significant anterior movements. But such benefits are a byproduct of the operation not its primary intent. Midface implants are more effective because they specifically target the desired areas of augmentation and are not dependent on where the underlying teeth are located.

Dr. Barry Eppley

Indianapolis, Indiana