Successful Downgrafts

[Eranthe]

Just wondering if anyone on here could let me know if they had a successful down-graft please. I require a revision down-graft as my surgeon removed too much vertical excess and now I have -0 tooth-show and diminished mid-face length which looks truly awful.

I am aware of the notorious instability of down-grafts, but they do seem to happen fairly often, so surely there must be success stories out there? If so, I would love to hear them. Thanks in advance

[Eranthe]

Just bumping this up in the hope that anyone who has had a down-graft will comment.
I would really love to get some idea of just how unstable/dangerous they are. Thanks

[Eranthe]

Just bumping this up again in the hope that anyone who has had a down-graft will comment.
I would really love to get some idea of just how unstable/dangerous they are. Thanks

[PierreDeFermat]

Maxillary downgrafts are fairly common and widely considered "stable," with long-term relapse of less than 2 mm in patients without bone grafts/HA implants, and less than 1 mm in patients with implants/bone grafts.

:Some links:

Maxillary stability following downgraft and/or advancement procedures with stabilization using rigid fixation and porous block hydroxyapatite implants
Wardrop RW, Wolford LM
J Oral Maxillofac Surg 47:336, 1989.

https://www.ncbi.nlm.nih.gov/pubmed/2926542

The long-term stability of LeFort I maxillary downgrafts with rigid fixation to correct vertical maxillary deficiency
Perez, DMD, MS a, Sameshima, DDS, PhD b, Sinclair, DDS, MSD
American Journal of Orthodontics & Dental Orthopedics July 1997 Volume 112, Issue 1, Pages 104–108

http://www.ajodo.org/article/S0889-5406 ... 4/fulltext



Is the same surgeon doing the revision? You might want to be careful of going to the same person that messed up the first time unless you absolutely trust them...

[Eranthe]

Thanks for your reply PierreDeFermat. I'm a public patient, and here in Australia we are treated by the MaxFac team at our local area hospital. My surgeon heads that department, so he and I are bound in a relationship of necessity. However, I do believe that he is a very good functional surgeon, but perhaps not as aesthetically inclined as I would have wished for. I think he works with a lot of trauma & accident victims and children with congenital anomalies.