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.


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 1horizontal 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 2pyramidal 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 3craniofacial 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.