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If the surgeon can , he can operate anything, there are many plastic surgeons, but not many are able to do lefort it an extremely rare procedure and there are very few surgeons that have experience with it, if they can, they can do anything.

please explain what that means. layman terms would be awesome


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Le Fort 3 osteotomy let  the surgeon to change the orbit position and volume cheek projection, position of the nose root, nose profile, and position of the maxilla.

I will explain very simple, touch your face. and your teeth. Ask yourself
those question do you have an overbite or underbite?
are your cheeks low and your face is flat?
Do you know what makes a very perfect face
it is the maxilla
the surgery that brings forward the maxilla , the maxilla when it is backwards flat faces, low cheeks, droppy eyes, nose profile, lack in the orbit area.

Le fort surgery 3 is a vey complex surgery that the surgeon highers the maxilla and brings it forward then screw it in place., there is no need for cheek implants, orbit implants, eyelid reconstruction, nose, overbite.
if it is done correctly by a very high qualified surgeon you can save all the costs of those operations in one.

Many of ffs surgeons are normal plastic surgeons yes they do jaw contouring, cheek reduction, facial implants but that is normal plastic surgery and to lift and sew skin ofcourse.

Iam in contact now, with a very qualified surgeon who does lefort3 and le fort 2 and 1 as well. He is also can do all surgeries once a surgeon can do lefort3 , he can anything.

Are there any good websites who explain this procedure in english? I think there is a bit of a language barrier here...

from my understanding then the surgeon can do the normal stuff but not use the implants? a website if u can plz


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My english is not my first language.
just google le fort3.
plastic surgeons have limitations in what they can do, cut and sew skin, some bone modelling.
Now if they can remove the maxilla, positions it back to the face where it is perfect position, forward it in the face, then they can do anything.

Goggle maxilla too.
Sluthate is the perfect site where it speaks about le fort 3.

Do you think this lefrot procedures should be part of a FFS?

Or do you only want to say that a surgeon who can do this is more skilled than others? The same would be true for surgeons who can fix hands - hand surgery is very complex, nerves have to be connected if a finger was severed, blood vessels connected, there is lots of tendons and muscles that need to be fixed - if someone can do this, he has to be very skilled as well. I would say that any surgeon who can do more complex things than bone remodelling or soft tissue shaping is certainly having more skills than a "simple" plastic surgeon - but then again, those who are extremely skille din these other things will not likely sepcialize on something like FFS and I personally like it if a person spacialzes, it leads to having more experience in that surgery compared to doing many other surgeries all the time and only doing FFS once a month

I had a LeFort III surgery. LeFort refers to the fractures of the skull: III is the cheeks, which they saw and shift outward or forward. They can also make the upper jaw, or mid-face shorter with a LeFort I and II

Any maxillofacial surgeon can do it. Maxilla is their main area of expertise.

LeFort I (red), II (blue), and III (green) fractures

(https://upload.wikimedia.org/wikipedia/commons/thumb/2/26/SchaedelSchraegLeFort123.png/800px-SchaedelSchraegLeFort123.png)

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fimg.medscape.com%2Fpi%2Femed%2Fckb%2Fclinical_procedures%2F79926-79932-1799897-1875019.jpg&hash=6f50619ac3740a940f834c1fb227d96b46515577)

That sounds pretty drastic and highly invasive. Is there not a greater risk of this surgery compared to regular FFS? Also in respect to scarring or nerve damage? Why is this not considered in FFS procedures more often - I never heard of it so far.

Quote from: anjaq on January 05, 2017, 12:37:21 PM
That sounds pretty drastic and highly invasive. Is there not a greater risk of this surgery compared to regular FFS? Also in respect to scarring or nerve damage? Why is this not considered in FFS procedures more often - I never heard of it so far.

Not sure why it's not done often... maybe because it's too expensive in a private clinic, and possibly more risk of complications. I can imagine that implants are easier and cheaper. Also, it requires much longer anesthesia and this in itself requires hospitalization in some countries. I had 12 hours of anesthesia of which 9 hours of constant surgery.

I had zero complications with a LeFort III. You can Google on: Zygoma osteotomy, which is LeFort III too. LeFort simply refers to the (natural) fracture areas of the skull. Any work done in these areas is a LeFort surgery. (as I understand it). See more below.

Zygoma osteotomy (in LeFort III area/fracture):

They saw the zygoma, and put a wedge in between. This pushes out the cheeks. To do this, they cut the upper gum line so there are no scars.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi.imgur.com%2FKI93qef.gif&hash=2357aa2487f949d16ee3d7415b0bc7270f8dfd32)

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.e-aps.org%2FArticleImage%2F2023APS%2Faps-39-333-g001-l.jpg&hash=b7df1086ae4d8ea9d4b1e659690a771589905be1)

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi60.tinypic.com%2F25rmovl.png&hash=d1ab8f12ff433ce043e52538ac1b7face57a193c)


LeFort system:

Le Fort fracture classification - Prof Frank Gaillard et al.

Le Fort fractures are fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. In order to be separated from the skull base the pterygoid plates of the sphenoid bone need to be involved as these connect the midface to the sphenoid bone dorsally. The Le Fort classification system attempts to distinguish according to the plane of injury.

Classification

The commonly used classification is as follows:

Le Fort type 1
horizontal maxillary fracture, separating the teeth from the upper face
fracture line passes through the alveolar ridge, lateral nose and inferior wall of maxillary sinus
Le Fort type 2
pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex
fracture arch passes through posterior alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones
Le Fort type 3
craniofacial dysjunction
fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall, and zygomatic arch / zygomaticofrontal suture
A memory aid is:

Le Fort 1 is a floating palate
Le Fort 2 is a floating maxilla
Le Fort 3 is a floating face

Any combination is possible. For example there may be type 2 on one side and type 3 on the other, or there may be type 1 and type 2 on the same side. Also Le Fort fractures can be associated with other facial fractures, neuromuscular injury and dental avulsions.

History and etymology

They are named after René Le Fort, French surgeon (1869-1951). Legend has it Le Fort did his work by dropping cannon balls on cadaver heads and then dissecting the results.

Ok, so I understand this sort of as an alternative to cheek implants, mainly? I do not like cheek implants so much, but this sounds like quite a drastic procedure to replace it...

In a way it makes the cheekbones larger by putting these wedges under them? It is curious because othes mentioned cheekbone reduction as part of their FFS - what really is it about cheekbones - is it a gendered facial marker, really - or is it more about beauty?

it changes the orbit area, cheeks and jaw.

Quote from: Abbiem on January 06, 2017, 05:29:45 AM
i want to know where you did lefort 3 with which surgeon

Ditto.

yes element of freedom, i have been asking her this question, who did lefort 3 for her?

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.maxillofaccialemonza.org%2Fwp-content%2Fuploads%2F2011%2F09%2F91.jpg&hash=39d188208868eb5388a19c6e345f022c385088c5)
This is Lefort osteotomy

Quote from: anjaq on January 05, 2017, 06:28:41 PM
Ok, so I understand this sort of as an alternative to cheek implants, mainly? I do not like cheek implants so much, but this sounds like quite a drastic procedure to replace it...

In a way it makes the cheekbones larger by putting these wedges under them? It is curious because othes mentioned cheekbone reduction as part of their FFS - what really is it about cheekbones - is it a gendered facial marker, really - or is it more about beauty?

It is not about cheekbones look at the photo i inserted it was a problem with her teeth bite, her face and eyes esp the orbit area, the cheeks, jaw in one operation, = lefort 3. Do you see the maxilla highered and brought forward, even the nose projection changed.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fpocketdentistry.com%2Fwp-content%2Fuploads%2F285%2FB9780323073714000109_f010-001-9780323073714.jpg&hash=cb20e9d91dcdc05cc968afc28f1fd3d6dd8a194f)

Quote from: anjaq on January 05, 2017, 06:28:41 PM
Ok, so I understand this sort of as an alternative to cheek implants, mainly? I do not like cheek implants so much, but this sounds like quite a drastic procedure to replace it...

In a way it makes the cheekbones larger by putting these wedges under them? It is curious because othes mentioned cheekbone reduction as part of their FFS - what really is it about cheekbones - is it a gendered facial marker, really - or is it more about beauty?

Yes, zygoma osteotomy is to create more cheek in those who have none (many males have underdeveloped zygoma.) which is done through a Le Fort III. Implants achieve the same result.

My surgeon is a local cranio-maxillofacial surgeon in a general hospital in my town. I don't think he does international patients, only local/national. He studies under Noorman van der Dussen, which is a kind of mentor for him. Noorman can do it too, he has the option listed on his website. In fact any maxillo facial surgeon could do it, but few are interested in feminizing faces. Maxillo facial surgeons usually only work on trauma victims, or physical deformities. Bart van der Ven is a maxillo facial surgeon too. He probably could do it if you asked for it.

When you take a look at the maxilla, it pretty much makes up your entire face.

It goes right up to the eye sockets and it even extends pretty deep into the face as well.

You can see that the size, shape & position of maxilla will touch everything from the nose, eyes, teeth alignment / palate, zygomatic / side cheekbones, and even the position of the lower jaw.

When you look at the significance of this 1 bone in its entirety, it begins to seem silly that people are only concerned with the teeth when things get crowded.


We can see with ample evidence that the maxilla has profound impact on appearance of eyes & nose.

If we had severe malocclusion, chances are one faces insecurities about eyes & nose because these are all at the effect of the maxilla shape & position.

& how the maxilla developed was at the effect of the tongue and jaw muscles.
http://claimingpower.com/maxilla-facial-beauty/

Quote from: 2cherry on January 06, 2017, 07:23:17 AM
Yes, zygoma osteotomy is to create more cheek in those who have none (many males have underdeveloped zygoma.) which is done through a Le Fort III. Implants achieve the same result.

My surgeon is a local cranio-maxillofacial surgeon in a general hospital in my town. I don't think he does international patients, only local/national. He studies under Noorman van der Dussen, which is a kind of mentor for him. Noorman can do it too, he has the option listed on his website. In fact any maxillo facial surgeon could do it, but few are interested in feminizing faces. Maxillo facial surgeons usually only work on trauma victims, or physical deformities. Bart van der Ven is a maxillo facial surgeon too. He probably could do it if you asked for it.

I dont think he does international patients huh? only local or nationalists, well i dont want to operate by a surgeon if he thinks this way.

Anyhow the lefort 3 is not only for cheeks, it is for those who have the bird look or their orbit area eyes, are missing volume, cheek volume, bite problems. They usually add orbit rims, cheek implants and reconstruct eyes for asymmetry but lefort 3 surgery one operate in one.

Quote from: Abbiem on January 06, 2017, 07:31:23 AM
I dont think he does international patients huh? only local or nationalists, well i dont want to operate by a surgeon if he thinks this way.

Excuse me? our hospitals are public, not private. It's the law in my country. But I could ask my surgeon, and that is what I am going to do. I'll post back with an answer.

I am still not sure how all of this relates to FFS. Obviously, if one has a deformed face, misaligned bite, protuding lowr jaw or therelike, it does make some sense to change thse things to appear more "normal" and more beautiful. But this seems to be true for men and women alike, so it appears to me to be more of a cosmetic beautification procedure that is rather radical and better only used when a significant issue occurs. The article lists nerve damage and other complications as rather common side effects - citing up to 25% patients who are regretting surgery.

I think it would help this forum, if you could explain why this is a facial gender issue and maybe you can tell us if there are surgeons knowing a lot about FFS and who incorporate this in their assessments? Are there any surgeons where one could for example send in photos and get an assessment if such a procedure makes sense, sepcifically in respect to the facial gender?

i understand you, it is like here 2, public hospitals by the government.
okay this is why your response, i get you.
No it is okay dont ask him.

Maybe it is a good idea to make one topic about this? instead of a dozen. Because it's very confusing... maybe a moderator can merge all these different but similar threads about Le Fort.

Otherwise, I won't read them all and might miss things.

Thank you.

Yes it relates to FFS Surgery, many of who are undergoing surgery do not know that their faces are formed according to their maxilla and their teeth, because it is OUR TEETH who makes a huge difference how our MAXILLAS are formed later in life.
This article is actually not about surgery it is about the maxilla and how the teeth can let the maxilla backwards or forward.
There are those who are shaving their jaws, adding cheek implants, orbit rim implants
without know that their teeth, bite problems like overbite underbite could have damaged their faces, breath problems and tjm, snoring problems.

FFS some do lefort  it is done not all do it yes it is done, but mind you orthognathic surgery is for all the wellbeing of the jaw, a jaw is not only long , there are dental issues many times because it is long, the maxilla forwarding is the wellbeing of dental and teeth inside the mouth, the teeth how we use them effects our faces later in life.

Therefore, when a surgeon to operate your face, will he look also at the dental too. The article, i referred is about how our faces changes due to maxilla changes, and our maxilla changes how we use our mouth and dental.

Quote from: 2cherry on January 06, 2017, 08:13:27 AM
Maybe it is a good idea to make one topic about this? instead of a dozen. Because it's very confusing... maybe a moderator can merge all these different but similar threads about Le Fort.

Otherwise, I won't read them all and might miss things.

Thank you.

i will try to put everything under one post, promise,  :angel:.

I just asked him.

He has to look into it if it's possible to do surgery on foreign patients. So I will get an answer from him.

Yes, he told me that he does Le Fort I very often. Le Fort I is upper jaw surgery, or double jaw if the lower is done as well. Le Fort II is uncommon he said. He also does Le Fort III. Also complete mid-face.

If I hear back from him, I'll post his name and details.

Quote from: Abbiem on January 06, 2017, 07:02:44 AM
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.maxillofaccialemonza.org%2Fwp-content%2Fuploads%2F2011%2F09%2F91.jpg&hash=39d188208868eb5388a19c6e345f022c385088c5)
This is Lefort osteotomy

Not positive,  but pretty sure this is a part of a long timeline series of pictures (I have seen them other places on the internet) of a patient with a serious original disfiguring syndrome at birth - -  who went through dozens of careful sequential craniofacial operations over a couple of decades before she ended up with the good result you see in the last picture.   

If this is the patient from the series I am thinking of,  then while interesting - -  this really has nothing to do with Facial Feminization,  other than it does show the set of surgical skills that are possessed by FFS surgeons who are trained and experienced in craniofacial surgery.

No it is actually not from a serie i will give you the site of the doctor.

This is not part of series, nor it took decades , this was done in Italy, one operation, lefort 3. And no series or nonsense.
Actually she was born with a deformity.
It is maxillary surgeons in Italy and they focus on the face, dental as well in whole.
She had underwent lefort 3.
There were no stages at all actually one operation and dental work and also written on their page.
here it is
http://www.maxillofaccialemonza.org/
why it is nothing to do with ffs surgery, maxillary surgery is part of ffs surgery, so in general surgery feminization is part of it maxillary and changing shape of jaw, cheek, orbit area.
to change the looks, so everything related to changing looks have to go under the knife, so it is all related.

Yes, I second myfairlad in that the pictures I found on these procedures seem to be almost exclusively about people having severe disfigurations, or stron over- or underbites. Of course, if this is y problem you have with the face, it should be adressed, ideally before doing ans other feminization procedures. But if ou do not have an overbie or underbite or otherwise deformed maxilla, I do not see the benefit of doing this.
I know some people get cheek implants, but I never heard of orbital rim implants beeing done on trans women for feminization - rather the opposite.

I think it would help if you can provide some more information on how this related to actually feminization of the face, maybe you can show some photos from the internet that show hoe these procedures are actually feminizing?

orbit rims under the eyes, not shaving the eyes forehead above orbit rims,
no, im stating what is lefort3, and it is done by maxillary surgeon the above and i stated the site, why cant u just go to the site and browse it. http://www.maxillofaccialemonza.org/
instead of just stating things.

Actually orbit rims implants, some surgeons subsitute it with "fat" under the eyes instead of orbit rims.
Now speaking about my face, this is not something iam discussing it is something else, when i want to discuss it, if i want to iam discussing her. Have you ever thought that she might have considered herself as a trans.
then, i have seen on ffs surgeon sites, people like her, and they have done it.
maybe some in a different way, i think double jaw surgery would be used, jaw shaved, then fat under her eyes,
instead of orbit rims, then nose surgery, dental work.
what i stated which SLUTHATE.COM states, that you can do plenty surgeries to fix a case like this
or do lefort 3 which fix it in one operation.

I can show some photos from ffs surgeon who had photos like this. But whatever check the Italian site so you can be assured , she was there as a client / patient. Instead of stating things.

Quote from: Abbiem on January 06, 2017, 10:16:40 PM
no, im stating what is lefort3, and it is done by maxillary surgeon the above and i stated the site, why cant u just go to the site and browse it. http://www.maxillofaccialemonza.org/
instead of just stating things.

I treid - but I do not speak any italian and from my attempts, I found mostly information on using this surgery to correct faces that are looking bad because of some maxillary issues. I do not really find really any photos there who show me that this is something that feminizes the face. As I said - if you have some maxilliary problem, of course it is something to consider, but assuming one has a regular and healthy maxilliary configuration - how would doing surgery on that feminize the face? That is what FFS is about after all - not about correcting other deformities but about facial gender perception. I am sure some transsexual people will have in addition ot facial gender issues also some maxilliary problems - which obviously should also be adressed - but that is independent of the whole gender issue, is it not?

QuoteHave you ever thought that she might have considered herself as a trans.
then, i have seen on ffs surgeon sites, people like her, and they have done it.
maybe some in a different way, i think double jaw surgery would be used, jaw shaved, then fat under her eyes,
instead of orbit rims, then nose surgery, dental work.
what i stated which SLUTHATE.COM states, that you can do plenty surgeries to fix a case like this
or do lefort 3 which fix it in one operation.

Who are you talking about now?

I am trying to understand, despite the language barrier. What I interpret now is that you are saying, a lefort 3 surgery can replace jaw shaving, rhinoplasty and cheek implants?

yes it replaces many operations in one, that is correct.

I would however say this then:
I believe it can only replace a rhinoplasty in some cases as it does not really solve some of the problems in FFS rhinoplasty - like making the nose smaller or less wide or removing the "bump" at the upper end. It probably can however straighten the nose and maybe even shape the tip a bit to tilt more upward?

It is a highly invasive surgery - so I am not sure it is a good tradeoff compared to the rather low invasive filling of cheeks with fat, fillers or even an implant - and even while jaw shaving is not without risk , as I read it so far, the risks are still  less than for this whole lefort surgery... so I am not sure if it is really an improvement to get one massive invasive surgery done compared to 2 or 3 less invasive surgeries? What makes it worth it?

Because i would rather forward my maxilla, not only for looks but health , breathing problems too.
Let me say that many of the surgeries are also involved for our health too. Like do you know that sometimes eyelids cannot make you see well, a bone cannot make you breath as well ect.
iam esp pro surgery when it involves in bettering health as well.
The maxilla if forwarded, will improve all the snoring, teeth itching, jaw pain as well.
Do you know that if you have perfect teeth, your face is usually developed well, when you miss teeth your face loses some shape.

So I assume that your maxilla is somehow backwards and it makes you look not as you like and also gives you health issues? You talk about snoring and itches and pain in the jaw, so I guess there is something wrong? In that case, by all means such a surgery may be a great thing to do. But its something special, isn't it? Its not like most men and trans women have their maxilla backwards and need to move it forward and most women have the maxilla forward already, or is there some gender difference in the maxilla position? I sadly have my wisdom teeth taken out, I did not like that, but they were making my other teeth crowded and the others started to overlap, so its better to not have them, I guess.

Yes my maxilla is back either facial implants or fat will fix this to give me higher cheeks, another thing i have assymetry with my eyes, i cannot nearly see well they have removed skin, so the became smaller and round, so iam making them larger from the sides or longer like they say and also fixing assymetry of spacing, the nose bone is blacking this and also the crease over my eyes, see when you remove is a bone in my nose which is not making me breath and iam fixing my nostrils.
now my jaw iam fixing too, with dental work., my jaw have made me have pain and itches, and snoring problems as well.
it is not only visual but also health too.
but this is for my face, not the body.