Will A LeFort I Impaction Shorten My Midface?

Q: Dr. Eppley, I’ve recently seen a question online asked by a user in regards to a midface shortening surgery using the lefort practice. You responded that such a surgery would not help since this would just burry the teeth if there were no abnormally long gums to begin with. 

Now to my question. Would a lefort 1 for example make sense if the outside skin or soft tissue could be removed from the above the lip, for example cut a bit of an area from above the lip then sow it back to the upper lip, or would a bullhorn liplift be enough to reduce the soft tissue for it to look normal? 

i understand that im not a professional but i think if only about 0,5cms of bone are removed it would be manageable, no?

A: While you can shorten the upper lip that will do nothing for the rest of the midface. In short there is nothing thaf can be done to shorten the long external midface. A LeFort I impaction reduces excessive gum show of the upper teeth but will not change the long external soft tissue midface.

Changing facial dimensions involves more variables than a diagrammatic exercise on a skeletal model. The effects on the external soft tissues do not correlate on a linear basis to what is done on the bone…and in the case of the midface bone shortening these is virtually no effect at all. 

Dr. Barry Eppley

World-Renowned Plastic Surgeon