Will Paranasal Implants Create More Upper Tooth Show?

Q: Dr. Eppley, I had a LeFort I osteotomy some years ago to help correct my bite, my upper jaw was very recessed. My upper jaw was moved slightly forward and corrected my bite, but it is still a bit recessed gives my midface a sunken look. Also, even though my teeth and bite look really good i do not show enough upper teeth, will the paranasal augmentation alleviate that a bit?

A: While midface augmentation through a variety of bone locations (cheek, infraorbital rim and paranasal regions) can help make the part of the face at or above the LeFort 1 level match and have equal augmentation, they will not create greater upper tooth show. Even though paranasal implants are placed iclose to the upper teeth, its augmentative effect is very unlikely to raise up the upper lip for increased tooth show. If paranasal augmentation is skeletally beneficial there are other ancillary procedures that can help create upper tooth show such as a subnasal lip lift or horizontal internal mucosal upper lip resection done at the high vestibular level.