Will A Maxillary Impaction Shorten My Nose?

Q: Dr. Eppley, If we were to impact the maxilla (LeFort 1), I understand the septum would also be trimmed by the corresponding amount. Wouldn’t this result in some shortening at least (perhaps not the full extent of the impacted amount )? Or is this largely variable and dependent mostly on how the soft tissue responds ? Even if post maxillary impaction, there is little or no shortening of the midface (brow to nose tip), if this is followed with rhinoplasty, does this actually increase the amount of shortening the nose can get (frontal view ) since the nasal cavity now is actually a little shorter ? (Septum trimmed by impacted amount and maxilla moved up wards ) 

Many thanks for your time

A: I am not sure I understand your question as it relates to ‘shortening’ whether this means midface shortening or nose shortening. But assuming it is the latter the nose will not shorten in height or length and make even make the nose look larger/longer. This is because no matter what is done wirh the underlying framework you still have the soft tissue coverage which is not changing. While it is tempting to view these concepts of facial change as a mathematical or from an engineering approach, that is not how the face will respond as it is not a 1:1 correlation. The soft tissue coverage must be accounted for and not being a hard structure its responses are not completely predictable.

Dr. Barry Eppley

Indianapolis, Indiana