Is it possible to get a quadrangular or high cut Lefort 1 for cosmetic reasons?

[bilasnk1]

Would any good surgeons actually perform this purely for aesthetics, or is a standard lf1 the only option?

 

[bilasnk1]

bump

 

[Gittes]

Would any good surgeons actually perform this purely for aesthetics, or is a standard lf1 the only option?

Yes, you can get it for cosmetic reasons.
Some surgeons argue the result isn’t very aesthetic though.

 

[bilasnk1]

Yes, you can get it for cosmetic reasons.
Some surgeons argue the result isn’t very aesthetic though.

i have a recessed paranasal area so a standard lf1 wouldnt work for that, i would also be getting infra implants so i think the result would be good

 

[Gittes]

i have a recessed paranasal area so a standard lf1 wouldnt work for that, i would also be getting infra implants so i think the result would be good

No, you can’t get Quadrangular + infraorbital implants because the plates fixating the advancement will be too high up the maxilla.

 

[bilasnk1]

No, you can’t get Quadrangular + infra orbital implants because the plates fixating the advancement will be too high up the maxilla.

oh i see, would it even be needed tho? fat grafting would probably be good enough unless giga recessed right

 

[Gittes]

oh i see, would it even be needed tho?

That was what a surgeon told me during consultation. I suppose it would be possible to get the plates removed post op, then get infraorbital implants.

fat grafting would probably be good enough unless giga recessed right

Alternatively, you could get an intermediate cut which advances the paranasal area and wouldn’t prevent you from getting infraorbital rim implants at the same time.

 

[bilasnk1]

That was what a surgeon told me during consultation. I suppose it would be possible to get the plates removed post op, then get infraorbital implants.

Alternatively, you could get an intermediate cut which advances the paranasal area and wouldn’t prevent you from getting infraorbital rim implants at the same time.

yeah might do that i guess ill just have to consult. I thought it was hard to find a surgeon to perform this tho

 

[Gittes]

yeah might do that i guess ill just have to consult. I thought it was hard to find a surgeon to perform this tho

It’s less common but there are definitely surgeons who do it. I raised it with a couple but they told me it wasn’t necessarily desirable to have more fullness beyond the jaws and that you want lateral not anterior projection of the cheekbones as a guy.

 

[monecel]

what about that modified lefort 2 that only moves the nose and the maxilla instead of the orbits?

 

[bilasnk1]

what about that modified lefort 2 that only moves the nose and the maxilla instead of the orbits?

it would probably be even harder to find a surgeon to perform this, but i think ik what ur talking about

 

[Gittes]

what about that modified lefort 2 that only moves the nose and the maxilla instead of the orbits?

Rare procedure and the results can be largely replicated with bimax + implants without the risk of cutting into the orbits.

 

[Gittes]

what about that modified lefort 2 that only moves the nose and the maxilla instead of the orbits?

Modified LeFort 2 mobilizes part of the orbital floor, not the nasal cavity:

Here's a result:

 

[kingofkings]

Modified LeFort 2 mobilizes part of the orbital floor, not the nasal cavity:


View attachment 5545555

Here's a result:

View attachment 5545559View attachment 5545561

He's prob referring to the latest cosmetic LF2 Giant case (tylin)

 

[Gittes]

He's prob referring to the latest cosmetic LF2 Giant case (tylin)

View attachment 5545743

What happened to that guy? Last thing I heard he privated his account after promising to be the first publicly documented LF2 case.

 

[kdl1721]

You could do that,Pagnoni does it.but there’s a catch: either you place the incision slightly higher than a standard Le Fort, or you perform a quadrangular Le Fort II that includes the infraorbital areas. Otherwise, the aesthetic result isn't really good, and you might end up with a bloated look between the infraorbital region and your cheekbones.there would be a step difference.Especially with the quadrangular Le Fort I meaning the type that doesn't fully encompass the infraorbital regions I don't think it yields an aesthetic result.A high projection infraorbital implant will be required in that case.

 

[bilasnk1]

You could do that,Pagnoni does it.but there’s a catch: either you place the incision slightly higher than a standard Le Fort, or you perform a quadrangular Le Fort II that includes the infraorbital areas. Otherwise, the aesthetic result isn't really good, and you might end up with a bloated look between the infraorbital region and your cheekbones.there would be a step difference.Especially with the quadrangular Le Fort I meaning the type that doesn't fully encompass the infraorbital regions I don't think it yields an aesthetic result.A high projection infraorbital implant will be required in that case.

yeah i mean i was thinking of getting infra implant too but idk, if i could get a quad lefort 2 i think that would be even better, do you have a pic of what the cut would look like btw?

 

[Gittes]

You could do that,Pagnoni does it.but there’s a catch: either you place the incision slightly higher than a standard Le Fort, or you perform a quadrangular Le Fort II that includes the infraorbital areas. Otherwise, the aesthetic result isn't really good, and you might end up with a bloated look between the infraorbital region and your cheekbones.there would be a step difference.Especially with the quadrangular Le Fort I meaning the type that doesn't fully encompass the infraorbital regions I don't think it yields an aesthetic result.A high projection infraorbital implant will be required in that case.

What would be the point of getting Quad 2 when you can be pretty much replicate it with a higher cut LF1 + infraorbital rim implants without cutting into orbitals?

yeah i mean i was thinking of getting infra implant too but idk, if i could get a quad lefort 2 i think that would be even better, do you have a pic of what the cut would look like btw?

Here's Quad 2 before and after. The change was negligible tbh - at least from the front.

 

[Animepilled]

Modified LeFort 2 mobilizes part of the orbital floor, not the nasal cavity:


View attachment 5545555

Here's a result:

View attachment 5545559View attachment 5545561

from invisible normie to invisible normie. projection is cope. its all about front ratios

 

[Gittes]

from invisible normie to invisible normie. projection is cope. its all about front ratios

Cutting up your midface and bringing it forward 5 mm is obviously not going to make you good looking. That being said, I do think forward growth is important up to a point but it's obviously been overstated to an absurd degree on here.

 

[sabafill]

What would be the point of getting Quad 2 when you can be pretty much replicate it with a higher cut LF1 + infraorbital rim implants without cutting into orbitals?

View attachment 5545995
Here's Quad 2 before and after. The change was negligible tbh - at least from the front.
View attachment 5545997

FINALLY SOMEONE GETS IT. Anything above LF1 for aesthetics is a meme.

 

[kdl1721]

What would be the point of getting Quad 2 when you can be pretty much replicate it with a higher cut LF1 + infraorbital rim implants without cutting into orbitals?

View attachment 5545995
Here's Quad 2 before and after. The change was negligible tbh - at least from the front.
View attachment 5545997

An implant doesn't produce exactly the same effect as an osteotomy; for instance, do you think placing implants across the entire midface yields the same result as a Le Fort III ? Furthermore, as the advancement distance in a high-cut Le Fort I increases, the projection power of an infraorbital implant would need to increase as well and excessive projection might look unnatural.and I also think quandrangular lefort 2 isnt logical for aesthetics,I just said that the incision line should be either slightly higher than a standard Le Fort 1 or a Le Fort 2 that includes the infraorbital areas; anything in between doesn't look good imo.

 

[kdl1721]

yeah i mean i was thinking of getting infra implant too but idk, if i could get a quad lefort 2 i think that would be even better, do you have a pic of what the cut would look like btw?

View attachment 5546276in mView attachment 5546287y opinionView attachment 5546288 this cut doesnt yield an aesthetic result beacuse there is a step difference between infraorbitals and cheeks,it would require a infraorbital implant with big projection.I also have one result of this you can clearly see she seems more bloated now.
But in my opinion, the height level marked in green for the incision for high cut lefort is a good choice. You can have infraorbital implants with it

 

[Gittes]

An implant doesn't produce exactly the same effect as an osteotomy;

It produces essentially the same result without the risk of cutting into the infraorbital nerve and orbital floor. It's arguably better because you augment the infraorbital rims instead of just bringing the existing structure forward.

for instance, do you think placing implants across the entire midface yields the same result as a Le Fort III ?

You can see the Quad LF2 result I posted earlier in this thread. There was basically no difference to the front. There's obviously a difference between augmenting the rims with implants and covering the entire midface in implants. I'm not going to compare apples and oranges just because you tell me to.

Furthermore, as the advancement distance in a high-cut Le Fort I increases, the projection power of an infraorbital implant would need to increase as well and excessive projection might look unnatural.

With quadrangular LF1 cuts you can't even place infraorbital implants because the plates are too high so I don't even know what you're talking about.

 

[kdl1721]

It produces essentially the same result without the risk of cutting into the infraorbital nerve and orbital floor. It's arguably better because you augment the infraorbital rims instead of just bringing the existing structure forward.

You can see the Quad LF2 result I posted earlier in this thread. There was basically no difference to the front. There's obviously a difference between augmenting the rims with implants and covering the entire midface in implants. I'm not going to compare apples and oranges just because you tell me to.

With quadrangular LF1 cuts you can't even place infraorbital implants because the plates are too high so I don't even know what you're talking about.

I didnt actually said that a quadrangular Le Fort II or I is logical; I just meant that regarding "high-cut Le Fort" procedures, it's better if the incision line isn't too high up ,so we're on the same page.I just dont think quandrangular lefort 1(red osteotomty line picture) doesnt yield an aesthetic result beacuse osteotomy line is between infras and cheeks.In my opinion, the osteotomy height indicated in green osteotomy picture is ideal for a high cut Le Fort I,and also infraorbital implant can be done with it.This result was achieved using the incision marked in red ostetomy picture; the girl looks more bloated because her infraorbital areas weren't advanced, even though her cheeks were. It doesn't look good.

 

[kdl1721]

yeah i mean i was thinking of getting infra implant too but idk, if i could get a quad lefort 2 i think that would be even better, do you have a pic of what the cut would look like btw?

just get this high cut lefort with infra implants imo

 

[Gittes]

I didnt actually said that a quadrangular Le Fort II or I is logical; I just meant that regarding "high-cut Le Fort" procedures, it's better if the incision line isn't too high up ,so we're on the same page.

I see, my mistake. No, we agree totally agree then.

I just dont think quandrangular lefort 1(red osteotomty line picture) doesnt yield an aesthetic result beacuse osteotomy line is between infras and cheeks.In my opinion, the osteotomy height indicated in green osteotomy picture is ideal for a high cut Le Fort I,and also infraorbital implant can be done with it.

I see where the confusion was. That green region is essentially Quadrangular LF1 though; you can tell because it cuts just below the infraorbital foramen on the left. You can't have that and infras because the plates used in fixation will get in the way.

This result was achieved using the incision marked in red ostetomy picture; the girl looks more bloated because her infraorbital areas weren't advanced, even though her cheeks were. It doesn't look good.

A major issue with Quad is that the cheeks are advanced anteriorly instead of laterally, which is what we really want.
This guy had LF1 + malar implants and achieved a much more satisfactory result than either the QLF1 or 2 results seen here - and without the risk!

 

[kdl1721]

I see, my mistake. No, we agree totally agree then.

I see where the confusion was. That green region is essentially Quadrangular LF1 though; you can tell because it cuts just below the infraorbital foramen on the left. You can't have that and infras.

A major issue with Quad is that the cheeks are advanced anteriorly instead of laterally, which is what we really want.
This guy had LF1 + malar implants and achieved a much more satisfactory result than either the QLF1 or 2 results seen here - and without the risk!
View attachment 5546362

it is (green marked)almost a quandrangular lf 1 but its osteotomy line isnt high as the red marked ostetomy picture .maybe its good for people with paranasal defiency but I agree with you

 

[Gittes]

it is (green marked)almost a quandrangular lf 1 but its osteotomy line isnt high as the red marked ostetomy picture .

It's still (comparatively) a very high cut; the difference looks so marginal to me that I still think plates would obstruct placement of infraorbital rim implants in this case but maybe I'm wrong. I don't know.