Questions about Lefort III Osteotomy

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Questions about Lefort III Osteotomy

#1 Post by eveningninja »

How do you know if you are eligible to have this surgery done? I'm going to be having 'jaw surgery' toward the end of this year for my underbite, and feel that my midface/cheekbones are very non-existent and underdeveloped, but my surgeon never mentioned Lefort III Osteotomy to me. I instead learned about it by just reading online, and feel that if I didn't have this surgery I'd be getting sort of shortchanged.

Can you opt to have Lefort III Osteotomy, and does medical insurance cover it or must you pay out of pocket?


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#2 Post by chicago29 »

You don't want a LeFort III...that is for complete facial reconstruction due to congenital defect or facial trauma. It is much more invasive, not to mention difficult. I don't know for sure, but I would bet there are many surgeons that don't even know how to do these as they are very specialized.

Do some more research, and you will see that they cut up to the orbital sockets of your eyes. There is a much bigger chance for severe complications such as blindness. Literally, well over half of your facial skeleton is cut and moved about in this procedure.

If your cheeks are a problem to you, I suggest you go to a cosmetic surgeon once your jaw surgery is done and inquire about cheek implants.

Also, I hate to speculate here, but are you pursuing jaw surgery purely for cosmetic benefits? If so, that is fine as that is certainly a component for most of us. Just please be sure you know what you are signing up for before you go further. Even the standard LeFort I surgery you are looking at carries risks and of course a difficult recovery.

Good luck in your decisions.





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#3 Post by ohmyjaw »

What procedure(s) does your surgeon have planned? If you are having a Lefort 1, you may get some improvement in the cheekbone area. Also, once your lower jaw is moved back, the middle of your face will naturally look more prominent. Another option is to have some bone grafts put in your cheeks during the surgery.

I would talk to your surgeon about your concerns.

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#4 Post by eveningninja »

Thanks for the replies.

Recovery time is not something I care about. Risks, that is one thing, I understand, but it seems surgery has come a long way in terms of technology, no?

And if I am already having standard jaw surgery anyway (forward movement of upper jaw and/or setback of lower jaw), would Lefort be covered by medical insurance?

And can surgeons give you a digital prediction/representation of what your face will look like with Lefort or similar jaw surgeries?

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#5 Post by AF104 »

A LeFort III osteotomy is a very specialized surgery done by cranio-facial plastic surgeons and generally in very specialized centers. You can't just opt for a LeFort III in lieu of a LeFort I. Often times both are needed at once. Insurance would almost certainly cover the procedure as it is reconstructive in nature. It's unlikely you need it though. Severe airway and eye symptoms would have likely been present for years if you needed such extreme surgery.

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#6 Post by eveningninja »

I see, so Lefort surgeries are not considered 'cosmetic' ? But are for functional purpose only?

Thanks again people for the responses.

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#7 Post by DotCat »

I am going to be extremely blunt here:

You do not want a le fort III surgery, unless you are ready to say bye bye to your sense of smell (80% chance of losing it) and are ready to accept the fact that you might end with disorted eyes, sight problems and many other risks related to the fact that they are operating on the base of your skull close to your brain as well as on the bottom end of your eye sockets. Also you would have a scar across from ear to ear throught your hair :(

These are the major reason why I refused Le Fort III even though I am a candidate for it with my Crouzon Syndrome and underdeveloped midface. If you have midface issues, you might want to check this type of implants: ... oducts.asp I am getting them myself to imitate the results of Le Fort III with only Le Fort I and implants (customised in my case).
Crouzon syndrome with midface hypoplasia and class III

SARPE, 7mm expansion - 14th September 2007
Lower braces on from 15th November 2007
Upper braces on from 17th January 2008
Hyrax RPE removed - 20th March 2008
Le Fort I advancement - 1st June 2009 (with major surgical complications)
Braces off from 25th March 2010, retainers on from 29th March 2010.


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#8 Post by eveningninja »

I see, thanks for the info. So can one 'opt' for Lefort I if I feel that my midface is lacking? The surgeon never mentioned this to me or anything like that, but I'm just wondering what I should say to him.

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#9 Post by Tribal »

Eveningninja, you said your surgeon wanted to do "forward movement of upper jaw and/or setback of lower jaw"... I'm pretty sure that the forward movement of you upper jaw is the LeForte I. You should bring up your concerns with your surgeon and ask him to get more technical with you if you desire it.

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#10 Post by Audra »

Eveningninja - I don't want to sound mean, but I think you need to do a little more research on Lefort surgery.

There are 3 different types of Lefort surgery, with Lefort 1 being the most typically done for people on this board. Lefort III, which is what you were asking about is major facial reconstruction. Lefort 1 is movement of the upper jaw, but the cuts are lower on the face than a Lefort 2 or Lefort 3.

I am having a Leforte 1 to move my upper jaw forward and am told this will add fullness to my upper face as my cheeks are somewhat flat.


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#11 Post by eveningninja »

I guess one of the things I'm concerned about is whether moving the upper jaw forward is an ideal choice for one with literally no cheekbones (from the side mine are like 100 percent flat). My surgeon didn't really seem to care much about what I thought about that lol. Because it probably wouldn't look good to have the upper jaw too forward with no cheekbones to support, right?

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