lefort 2, bimax, genioplasty, jaw surgery advice

[ptown069]

I have a Class III malocclusion (underbite) and have worn braces with elastics to partially correct it. My two lower wisdom teeth were extracted due to lack of space. I also have significant midface (maxilla) and chin recession, with noticeable facial asymmetry — my right side is more developed and forward-grown, while my left side has a narrower jaw, flatter cheekbone, and a more horizontal ramus angle, which makes the underbite more obvious on that side.

My orthodontist confirmed insurance will cover jaw surgery, and I’m planning to get:

• Maxilla advancement and impaction(hopefully lefort 2) and counterclockwise (CCW) rotation to shorten my long face and bring forward projection
• Mandibular surgery to correct the underbite and asymmetry
• Genioplasty to advance my recessed chin
• Zygomatic repositioning for defintion, projection and sharp ogee curve hopefully

I also struggle with chewing and swallowing, as my airway is only 4 mm wide instead of the normal 12 mm (diagnosed at age 12). Because of this, my head posture leans forward for easier breathing. I often spit while talking or eating and have a slight lisp, likely from my underbite.

My upper teeth jut forward to compensate for the underbite — my orthodontist suggested extractions to bring them back in vertically, but I’d rather avoid that. Are there alternative options to align them without extractions?

My goal is to achieve forward facial growth, a balanced side profile, fix asymmetry and better definition in my lower third, chin, and cheekbones (zygos) — ideally with a sharp OGEE curve.

Would I qualify for LeFort II, maxilla impaction, zygomatic repositioning, CCW rotation, ramus contouring, and genioplasty? I live in Australia if that helps.


In photos 5–6, I puff my lips to simulate the results of maxilla advancement/impaction, which I think would also correct my drooped nose — does this seem accurate? In the last photo i have a photo of my bite as you can see the forward jutt of my upper teeth barely compensates for my underbite.

 

[ptown069]

i also want to correct my infraorbital recession and my bug likeish eyes cus of maxilla recession and a higher more projected nose and nose bridge which im hoping lefort 2 will fix.

 

[shngstaaaa107]

Can't help much but I'll bump this post, hope you can find good advice.

 

[shngstaaaa107]

BUmp

 

[slickjensen]

most people here will dnr this post because of shit attention spans but I wouldn’t worry about not qualifying for surgery this definitely needs surgical attention, bump

 

[Foreverbrad]

I am not normally judgemental but I felt instinctively repulsed by your photos. It’s that bad. I’m sorry.

Only RSM is doing cosmetic Lefort 2/3 so you’d pretty much be in the territory of “medical reasons” which nobody on here knows about as they are all narcy HTN teenagers.

Tag me if there is any update in your situation regarding what you are offered as a “medically necessary” solution. I think LF2 in this case is strongly indicated cosmetically as your midface is pretty much dead flat.

 

[ptown069]

I am not normally judgemental but I felt instinctively repulsed by your photos. It’s that bad. I’m sorry.

Only RSM is doing cosmetic Lefort 2/3 so you’d pretty much be in the territory of “medical reasons” which nobody on here knows about as they are all narcy HTN teenagers.

Tag me if there is any update in your situation regarding what you are offered as a “medically necessary” solution. I think LF2 in this case is strongly indicated cosmetically as your midface is pretty much dead flat.

why would the lefort 2 be cosmetic, i dont think a cosmetic lefort 2 is ever offererd, cus i assumed it would be covered by insurance as in my case id say its deemed medically necessary, food stuck in my throat everytime i eat, forward head posture from narrow airway, an airway 3x smaller than average, and i have troubles breathing when i sleep. for these reasons i mean i would say its medically necessary not cosmetic, my bite is also terrible with huge forward jutt of my upper teeth compensating for my severe underbite which also accentuates my maxilla recession.

 

[wrestle.cel]

Bumping ts so someone higher iq than me can help you

 

[PrimoMaxxer]

I think Andrew Heggie from Melbourne does lf2. He's like 80 though

 

[PrimoMaxxer]

Doesn't specifically say if lf2 was done here, but probably was?

 

[william.]

realistically you'll just get trimax with lefort 1

 

[ptown069]

realistically you'll just get trimax with lefort 1

alright but under what circumstances would lefort 2 qualify for, i just dont think a lefort 1 would solve the issues i have cus my recession goes all the way up to my eyes and the top of my nasal bridge, lefort 1 doesnt go up that high so it wouldnt really fix much

 

[william.]

alright but under what circumstances would lefort 2 qualify for, i just dont think a lefort 1 would solve the issues i have cus my recession goes all the way up to my eyes and the top of my nasal bridge, lefort 1 doesnt go up that high so it wouldnt really fix much

idk, but lefort 2 is extremely rare

u can do rhino and implants later

 

[kingofkings]

An alternative option would be a modified quadrangular Le Fort I osteotomy. In the paper below it was designed in mind for Asians with infra and maxilla hypoplasia

Soft tissue changes and skeletal stability after modified quadrangular Le Fort I osteotomy - PubMed

The purpose of this study was to evaluate the soft tissue changes and skeletal stability of a modification of the Le Fort I osteotomy design - the modified quadrangular Le Fort I osteotomy (MQLI). Patients who had maxillary advancement and mandibular setback surgery for skeletal class III...

pubmed.ncbi.nlm.nih.gov

I came across this paper a while back whilst researching about quad leforts. You can try emailing the authors for more information, in my experience such people are fairly responsive to enquiries

 

[ptown069]

An alternative option would be a modified quadrangular Le Fort I osteotomy. In the paper below it was designed in mind for Asians with infra and maxilla hypoplasia

Soft tissue changes and skeletal stability after modified quadrangular Le Fort I osteotomy - PubMed

The purpose of this study was to evaluate the soft tissue changes and skeletal stability of a modification of the Le Fort I osteotomy design - the modified quadrangular Le Fort I osteotomy (MQLI). Patients who had maxillary advancement and mandibular setback surgery for skeletal class III...

pubmed.ncbi.nlm.nih.gov

I came across this paper a while back whilst researching about quad leforts. You can try emailing the authors for more information, in my experience such people are fairly responsive to enquiries

very helpful thank you

 

[mewael]

I have a Class III malocclusion (underbite) and have worn braces with elastics to partially correct it. My two lower wisdom teeth were extracted due to lack of space. I also have significant midface (maxilla) and chin recession, with noticeable facial asymmetry — my right side is more developed and forward-grown, while my left side has a narrower jaw, flatter cheekbone, and a more horizontal ramus angle, which makes the underbite more obvious on that side.

My orthodontist confirmed insurance will cover jaw surgery, and I’m planning to get:

• Maxilla advancement and impaction(hopefully lefort 2) and counterclockwise (CCW) rotation to shorten my long face and bring forward projection
• Mandibular surgery to correct the underbite and asymmetry
• Genioplasty to advance my recessed chin
• Zygomatic repositioning for defintion, projection and sharp ogee curve hopefully

I also struggle with chewing and swallowing, as my airway is only 4 mm wide instead of the normal 12 mm (diagnosed at age 12). Because of this, my head posture leans forward for easier breathing. I often spit while talking or eating and have a slight lisp, likely from my underbite.

My upper teeth jut forward to compensate for the underbite — my orthodontist suggested extractions to bring them back in vertically, but I’d rather avoid that. Are there alternative options to align them without extractions?

My goal is to achieve forward facial growth, a balanced side profile, fix asymmetry and better definition in my lower third, chin, and cheekbones (zygos) — ideally with a sharp OGEE curve.

Would I qualify for LeFort II, maxilla impaction, zygomatic repositioning, CCW rotation, ramus contouring, and genioplasty? I live in Australia if that helps.


In photos 5–6, I puff my lips to simulate the results of maxilla advancement/impaction, which I think would also correct my drooped nose — does this seem accurate? In the last photo i have a photo of my bite as you can see the forward jutt of my upper teeth barely compensates for my underbite.

Yeah you definitely need left but not lerft 3 since then they also move orbitals. It's high risk high reward.

Even a lot of people get cooked by lerft 2 imagine 3 just stick with 2 or 1. But do as you wish I don't how you could be feeling

 

[ptown069]

Yeah you definitely need left but not lerft 3 since then they also move orbitals. It's high risk high reward.

Even a lot of people get cooked by lerft 2 imagine 3 just stick with 2 or 1. But do as you wish I don't how you could be feeling

yeah not lefort 3 i didnt mention lefort 3, but would u say id meet the qualifications for a lefort 2

 

[tiredman]

These kind of idiots don't have the money and insist on having extremely complicated surgeries even though they don't need them. It's nirvana in stupidity.

 

[Sicilian Cyclops]

These kind of idiots don't have the money and insist on having extremely complicated surgeries even though they don't need them. It's nirvana in stupidity.

This guy definitely needs a higher level Le Fort, his nasion projection is fucked. Bimax with a normal LF1 will just further dogmax him, also cartilage grafting/radix implant likely wont be enough either for a satisfactory result either.

 

[Sicilian Cyclops]

@RealSurgerymax help this poor gook

 

[Sicilian Cyclops]

Doesn't specifically say if lf2 was done here, but probably was?

A monobloc was probably done, Le Fort 2 wouldn't be enough for Crouzons or whatever syndrome that kid has

 

[RealSurgerymax]

I have a Class III malocclusion (underbite) and have worn braces with elastics to partially correct it. My two lower wisdom teeth were extracted due to lack of space. I also have significant midface (maxilla) and chin recession, with noticeable facial asymmetry — my right side is more developed and forward-grown, while my left side has a narrower jaw, flatter cheekbone, and a more horizontal ramus angle, which makes the underbite more obvious on that side.

My orthodontist confirmed insurance will cover jaw surgery, and I’m planning to get:

• Maxilla advancement and impaction(hopefully lefort 2) and counterclockwise (CCW) rotation to shorten my long face and bring forward projection
• Mandibular surgery to correct the underbite and asymmetry
• Genioplasty to advance my recessed chin
• Zygomatic repositioning for defintion, projection and sharp ogee curve hopefully

I also struggle with chewing and swallowing, as my airway is only 4 mm wide instead of the normal 12 mm (diagnosed at age 12). Because of this, my head posture leans forward for easier breathing. I often spit while talking or eating and have a slight lisp, likely from my underbite.

My upper teeth jut forward to compensate for the underbite — my orthodontist suggested extractions to bring them back in vertically, but I’d rather avoid that. Are there alternative options to align them without extractions?

My goal is to achieve forward facial growth, a balanced side profile, fix asymmetry and better definition in my lower third, chin, and cheekbones (zygos) — ideally with a sharp OGEE curve.

Would I qualify for LeFort II, maxilla impaction, zygomatic repositioning, CCW rotation, ramus contouring, and genioplasty? I live in Australia if that helps.


In photos 5–6, I puff my lips to simulate the results of maxilla advancement/impaction, which I think would also correct my drooped nose — does this seem accurate? In the last photo i have a photo of my bite as you can see the forward jutt of my upper teeth barely compensates for my underbite.

@RealSurgerymax help this poor gook

He qualifies for it at giant, and we are the only ones who did a custom lefort 2, in the world, and it was a success.

If he means through insurance, of course he wont ascend much, and I am not motivated to help if not coming to me.

 

[ptown069]

He qualifies for it at giant, and we are the only ones who did a custom lefort 2, in the world, and it was a success.

If he means through insurance, of course he wont ascend much, and I am not motivated to help if not coming to me.

how do i contact you

 

[mewael]

yeah not lefort 3 i didnt mention lefort 3, but would u say id meet the qualifications for a lefort 2

Not really you have an underbite, so you should only do upper maxilary surgery to put it more forward, double surgery isn't really necessary.

 

[Localcat12345]

I have a Class III malocclusion (underbite) and have worn braces with elastics to partially correct it. My two lower wisdom teeth were extracted due to lack of space. I also have significant midface (maxilla) and chin recession, with noticeable facial asymmetry — my right side is more developed and forward-grown, while my left side has a narrower jaw, flatter cheekbone, and a more horizontal ramus angle, which makes the underbite more obvious on that side.

My orthodontist confirmed insurance will cover jaw surgery, and I’m planning to get:

• Maxilla advancement and impaction(hopefully lefort 2) and counterclockwise (CCW) rotation to shorten my long face and bring forward projection
• Mandibular surgery to correct the underbite and asymmetry
• Genioplasty to advance my recessed chin
• Zygomatic repositioning for defintion, projection and sharp ogee curve hopefully

I also struggle with chewing and swallowing, as my airway is only 4 mm wide instead of the normal 12 mm (diagnosed at age 12). Because of this, my head posture leans forward for easier breathing. I often spit while talking or eating and have a slight lisp, likely from my underbite.

My upper teeth jut forward to compensate for the underbite — my orthodontist suggested extractions to bring them back in vertically, but I’d rather avoid that. Are there alternative options to align them without extractions?

My goal is to achieve forward facial growth, a balanced side profile, fix asymmetry and better definition in my lower third, chin, and cheekbones (zygos) — ideally with a sharp OGEE curve.

Would I qualify for LeFort II, maxilla impaction, zygomatic repositioning, CCW rotation, ramus contouring, and genioplasty? I live in Australia if that helps.


In photos 5–6, I puff my lips to simulate the results of maxilla advancement/impaction, which I think would also correct my drooped nose — does this seem accurate? In the last photo i have a photo of my bite as you can see the forward jutt of my upper teeth barely compensates for my underbite.

Yes you would qualify and it would improve your situation a lot

 

[Sicilian Cyclops]

how do i contact you

his instagram https://www.instagram.com/giant.implants/