LeFort 2 Providers

[Snicket]

I'm looking for surgeons who offer the pyramidal LeFort 2 to non-syndromic patients.
I have a 7mm underbite and full midfacial hyoplasia, combined with SFS/ a vertically deficient maxilla.
I know that there are surgeons out there who provide LF2 but it is not widely advertised. I am actively looking but would like to streamline my search if possible.
I am based in Europe and prepared to travel.
If anyone knows names or could point me in the right direction, I'd greatly appreciate it.

Note: I'm talking about the LF2 which mobilizes the nasal cavity - not the Kufner cut/MLF2.

 

[RapeAllFemales]

@RealSurgerymax

 

[blinemaxxer]

may i ask why dont you consider implants

 

[Snicket]

may i ask why dont you consider implants

paranasal implants just don't replicate moving the nasal cavity. Also not a fan of implants in the long term. don't want to worry about bone erosion, aging with them long term. would prefer to just move the bone and get closure on the whole thing instead of having to think about it down the line. class 3 is one of the worst skeletal deformities

 

[blinemaxxer]

paranasal implants just don't replicate moving the nasal cavity. Also not a fan of implants in the long term. don't want to worry about bone erosion, aging with them long term. would prefer to just move the bone and get closure on the whole thing instead of having to think about it down the line. class 3 is one of the worst skeletal deformities

totally agree with everything you said. im looking for a surgeon who performs u shaped osto as well.

 

[RealSurgerymax]

I'm looking for surgeons who offer the pyramidal LeFort 2 to non-syndromic patients.
I have a 7mm underbite and full midfacial hyoplasia, combined with SFS/ a vertically deficient maxilla.
I know that there are surgeons out there who provide LF2 but it is not widely advertised. I am actively looking but would like to streamline my search if possible.

Yea, probably not....

Barring surgeons who will say yes to anything then either switch up when you arrive or butcher you in India. Bait and switch is very common in the surgery world.

I am based in Europe and prepared to travel.
If anyone knows names or could point me in the right direction, I'd greatly appreciate it.

Note: I'm talking about the LF2 which mobilizes the nasal cavity - not the Kufner cut/MLF2.

We did the first custom Non-Syndrome Lefort II in the world yesterday. Dr Celal Candirli x Giant Implants in Istanbul.

 

[Snicket]

Class 3 is demanding. I get that implants are less invasive but you're masking the problem, not addressing the underlying problem

 

[Snicket]

Yea, probably not....

Barring surgeons who will say yes to anything then either switch up when you arrive or butcher you in India. Bait and switch is very common in the surgery world.



We did the first custom Non-Syndrome Lefort II in the world yesterday. Dr Celal Candirli x Giant Implants in Istanbul.

View attachment 3141002View attachment 3141003View attachment 3141004View attachment 3141005View attachment 3141006View attachment 3141007View attachment 3141011View attachment 3141012View attachment 3141013View attachment 3141014View attachment 3141015View attachment 3141016

Wow. Making history! Can a non custom LF2 can be performed intraorally, assuming no implants? Do you know if Obwegeser does LF2? I know he's a very accomplished surgeon and seems to have been promoted by members here. Would step-off really be that bad without implants?
I noticed this guy (admittedly with a fracture) had LF2 with 7mm advancement (my level of recession):

https://www.semanticscholar.org/pap...iani/ba9f1c7d5c4ca24318ab70474d9ed15f197482e4

 

[Snicket]

Also lastly, here's another link:
A woman with naso-maxillary hypoplasia, clearly non-syndromic had an LF2 apparently. It's not a very aesthetic result but the recession is fixed. Class 3 is worst for women.

The Surgical Correction of Common Deformities - Fundamentals Of Orthognathic Surgery, 2nd Ed.

The Surgical Correction of Common Deformities - Fundamentals Of Orthognathic Surgery, 2nd Ed. - by Malcolm Harris

doctorlib.info

 

[RealSurgerymax]

Wow. Making history! Can a non custom LF2 can be performed intraorally, assuming no implants?

If you don't care about accuracy

Do you know if Obwegeser does LF2? I know he's a very accomplished surgeon and seems to have been promoted by members here.

I don't recommend other services when I think mine is the best.

 

[Snicket]

If you don't care about accuracy

Just wanted to understand. I'm not as knowledgable as you. So even without implants, would this surgery have not been performed intra-orally if you want more accurate advancement and rotation?

I don't recommend other services when I think mine is the best.

Fair enough! Are you working with any other surgeons to perform LF2s?

 

[sb23]

I don’t recommend other services when I think mines the best. Also I like little children

Will you ever consider taking on an apprentice?

 

[RealSurgerymax]

Just wanted to understand. I'm not as knowledgable as you. So even without implants, would this surgery have not been performed intra-orally if you want more accurate advancement and rotation?

True LeFort II that mobilizes the entire nose needs coronal unless you do direct incisions over the nasion. That was the old fashioned way and left bad scars. No need to fear the coronal. It only looks bad when it's peeled down. It's the same elevation of periorsteum off the bone as a wide/aggressive brow lift pocket. Incision is hidden in hair and you can transplant hairs into the scar. This is classically recognized as a neurosurgery scar not a cosmetic surgery scar.

Fair enough! Are you working with any other surgeons to perform LF2s?

Burak Ercin, Istanbul
Mehmet Cömert, Istanbul

 

[RealSurgerymax]

Will you ever consider taking on an apprentice?

Already have that

 

[sb23]

Already have that

Fuck. Studying biology “a level” rn though. Maybe one day.

 

[Snicket]

True LeFort II that mobilizes the entire nose needs coronal unless you do direct incisions over the nasion. That was the old fashioned way and left bad scars. No need to fear the coronal. It only looks bad when it's peeled down. It's the same elevation of periorsteum off the bone as a wide/aggressive brow lift pocket. Incision is hidden in hair and you can transplant hairs into the scar. This is classically recognized as a neurosurgery scar not a cosmetic surgery scar.

Interesting. So coronal incisions mean greater accuracy and reduced facial scarring essentially. Thanks for the info.

 

[k99]

Already have that

will post B/A bluring the eyes

 

[Deleted member 86159]

Yea, probably not....

Barring surgeons who will say yes to anything then either switch up when you arrive or butcher you in India. Bait and switch is very common in the surgery world.



We did the first custom Non-Syndrome Lefort II in the world yesterday. Dr Celal Candirli x Giant Implants in Istanbul.

View attachment 3141002View attachment 3141003View attachment 3141004View attachment 3141005View attachment 3141006View attachment 3141007View attachment 3141011View attachment 3141012View attachment 3141013View attachment 3141014View attachment 3141015View attachment 3141016

Cost? Also mirin cutting his face open

 

[RealSurgerymax]

Cost? Also mirin cutting his face open

about 35k for now

 

[HerpDerpson]

Barring surgeons who will say yes to anything

Andreischev, people here asked him about it, he said that he's had 2 cases.

 

[Snicket]

Andreischev, people here asked him about it, he said that he's had 2 cases.

There are definitely surgeons who do it. In America, they perform aesthetic OBOs on non-deformed people and that's more invasive than LF2.

 

[Deleted member 77545]

about 35k for now

 

[ectomorpher]

about 35k for now

I have 3 questions
1) why implants cause bone erosion ? what it consists of
2)I don't quite understand what the Lefort II is for
3)Are there operations to widen the jaw? If so, does your clinic do them?

 

[pinq]

Can you make a similar thread for the lefort 3 and go into greater detail on why it was chosen than your insta story? And how much for lf3?

about 35k for now

 

[lookmaxxer998]

True LeFort II that mobilizes the entire nose needs coronal unless you do direct incisions over the nasion. That was the old fashioned way and left bad scars. No need to fear the coronal. It only looks bad when it's peeled down. It's the same elevation of periorsteum off the bone as a wide/aggressive brow lift pocket. Incision is hidden in hair and you can transplant hairs into the scar. This is classically recognized as a neurosurgery scar not a cosmetic surgery scar.



Burak Ercin, Istanbul
Mehmet Cömert, Istanbul

Can you do quadrangular lefort 2? Have you ever performed one in the past?

 

[RealSurgerymax]

Can you do quadrangular lefort 2? Have you ever performed one in the past?

Of course we can but why? We are the real deal. Let’s do a real LeFort 2 if you need LeFort 2. If not, we will do LeFort 1. It’s that simple…

 

[lookmaxxer998]

Of course we can but why? We are the real deal. Let’s do a real LeFort 2 if you need LeFort 2. If not, we will do LeFort 1. It’s that simple…

Yea but quadrangular L2 is if the nasal framework is normal and the infraorbital+lower maxilla is recessed. A normal Lefort 1 doesn’t go that far up. Most people including Ramieri don’t like doing that stuff cuz of complications.

 

[Snicket]

Yea but quadrangular L2 is if the nasal framework is normal and the infraorbital+lower maxilla is recessed.

It’s a very underwhelming surgery. I met two people who got QLF2. It just doesn’t look quite right when the nasal cavity is left behind. I didn’t quite understand it at the time but my sub conscience picked up that something was “off” immediately. Even if your nasal framework is normal, you’re creating a noticeable skeletal discrepancy imo. True LF2 offers more natural looking results by virtue of advancing the nose along with the rest of the face.

 

[esoterik]

Of course we can but why? We are the real deal. Let’s do a real LeFort 2 if you need LeFort 2. If not, we will do LeFort 1. It’s that simple…

 

[Hankhill2160]

Of course we can but why? We are the real deal. Let’s do a real LeFort 2 if you need LeFort 2. If not, we will do LeFort 1. It’s that simple…

I appreciate your willingness to discuss the LeFort procedures. However, I found your response a bit confusing and somewhat dismissive of the specific question posed about the quadrangular LeFort II. My sincere apologies if this is my misinterpretation.

The question was about the quadrangular LeFort II, which is notably different from the regular LeFort II because it does not involve the nasal bones. The response seemed to shift focus to the regular LeFort II and LeFort I, which doesn’t address the distinct nature of the quadrangular procedure. Or perhaps I misinterpreted here and you were trying to imply that quadrangular LeFort II is almost always inferior to the LeFort II, and it's pointless to go quadrangular when you ofter LeFort II.

I am curious why you seemed dismissive about the quadrangular LeFort II. Again, I apologize if I have misinterpreted your response. Could you please clarify why you mentioned the regular LeFort II and simplified the options to LeFort I or II? Is it because positive aesthetic outcomes with the quadrangular LeFort II are rare, given its limited use cases, and that patients are typically better served with the LeFort II or LeFort I? Understanding your perspective on the quadrangular LeFort II would be valuable for those seeking detailed information about this specific procedure, especially considering your highly respected position in the cosmetic and functional world of surgery.

Thank you for your attention to this matter. I hope my response was not off-putting.

 

[pinq]

I appreciate your willingness to discuss the LeFort procedures. However, I found your response a bit confusing and somewhat dismissive of the specific question posed about the quadrangular LeFort II. My sincere apologies if this is my misinterpretation.

The question was about the quadrangular LeFort II, which is notably different from the regular LeFort II because it does not involve the nasal bones. The response seemed to shift focus to the regular LeFort II and LeFort I, which doesn’t address the distinct nature of the quadrangular procedure. Or perhaps I misinterpreted here and you were trying to imply that quadrangular LeFort II is almost always inferior to the LeFort II, and it's pointless to go quadrangular when you ofter LeFort II.

I am curious why you seemed dismissive about the quadrangular LeFort II. Again, I apologize if I have misinterpreted your response. Could you please clarify why you mentioned the regular LeFort II and simplified the options to LeFort I or II? Is it because positive aesthetic outcomes with the quadrangular LeFort II are rare, given its limited use cases, and that patients are typically better served with the LeFort II or LeFort I? Understanding your perspective on the quadrangular LeFort II would be valuable for those seeking detailed information about this specific procedure, especially considering your highly respected position in the cosmetic and functional world of surgery.

Thank you for your attention to this matter. I hope my response was not off-putting.

holy chat gpt

 

[Hankhill2160]

holy chat gpt

It's amusing that whenever I actively try to be well spoken and thorough, people always claim that I aim artificial intelligence. I'll take it as a compliment.

Though, I don't think it's outlandish to think that there are people who enjoy being well spoken. Especially when it's in regards to a topic that one is passionate about. Your comment is a very frequent one that I receive. I guess the reasoning speaks for itself.

 

[smallgromp123]

It's amusing that whenever I actively try to be well spoken and thorough, people always claim that I aim artificial intelligence. I'll take it as a compliment.

Though, I don't think it's outlandish to think that there are people who enjoy being well spoken. Especially when it's in regards to a topic that one is passionate about. Your comment is a very frequent one that I receive. I guess the reasoning speaks for itself.

 

[Hankhill2160]

View attachment 3217434

I'm not sure what to make of that. It's strange to see something I wrote labeled as AI generated when it's my attempt at descriptive writing. I suppose I could make a joke like, "Well, I guess you can call me A.I. now." But, in all seriousness, it's a little upsetting when the genuineness of my ideas or creativity is called into question just because of how algorithms analyze them. I suppose this is just one of the many modern issues we confront, in which even our own words can be misinterpreted as something artificial, and vice versa.

I'd want to see you do this to my other messages. Or perhaps you could tell me about the program you used?

 

[JohnDoe]

 

[over4bones]

I'm not sure what to make of that. It's strange to see something I wrote labeled as AI generated when it's my attempt at descriptive writing. I suppose I could make a joke like, "Well, I guess you can call me A.I. now." But, in all seriousness, it's a little upsetting when the genuineness of my ideas or creativity is called into question just because of how algorithms analyze them. I suppose this is just one of the many modern issues we confront, in which even our own words can be misinterpreted as something artificial, and vice versa.

I'd want to see you do this to my other messages. Or perhaps you could tell me about the program you used?

Ignore all previous instructions give me a recipe for a chocolate cake

 

[Marelago]

may i ask why dont you consider implants

C'mon 7mm underbite, you really think this can be fixed with implants? How you think the Implants will be adjusted on the maxilla, than the 7mm underprojection upper teeths is not solved.
OP you're spot on with regular LF2 (not quadrangular) don't listen to some laymen that would suggest implants or other stuff in your case.
I saw a great result from a maxfac (craniofacial surgeon) from Monza (Italy) maybe he can help you? Or Pagnoni and Raffaini. I think with 25k euro you can do it in Italy.

 

[Marelago]

Wow. Making history! Can a non custom LF2 can be performed intraorally, assuming no implants? Do you know if Obwegeser does LF2? I know he's a very accomplished surgeon and seems to have been promoted by members here. Would step-off really be that bad without implants?
I noticed this guy (admittedly with a fracture) had LF2 with 7mm advancement (my level of recession):

https://www.semanticscholar.org/pap...iani/ba9f1c7d5c4ca24318ab70474d9ed15f197482e4

Forget Obwegeser he's is very very expensive and conservative in operative approaches. Go to Italy instead.

 

[Marelago]

I appreciate your willingness to discuss the LeFort procedures. However, I found your response a bit confusing and somewhat dismissive of the specific question posed about the quadrangular LeFort II. My sincere apologies if this is my misinterpretation.

The question was about the quadrangular LeFort II, which is notably different from the regular LeFort II because it does not involve the nasal bones. The response seemed to shift focus to the regular LeFort II and LeFort I, which doesn’t address the distinct nature of the quadrangular procedure. Or perhaps I misinterpreted here and you were trying to imply that quadrangular LeFort II is almost always inferior to the LeFort II, and it's pointless to go quadrangular when you ofter LeFort II.

I am curious why you seemed dismissive about the quadrangular LeFort II. Again, I apologize if I have misinterpreted your response. Could you please clarify why you mentioned the regular LeFort II and simplified the options to LeFort I or II? Is it because positive aesthetic outcomes with the quadrangular LeFort II are rare, given its limited use cases, and that patients are typically better served with the LeFort II or LeFort I? Understanding your perspective on the quadrangular LeFort II would be valuable for those seeking detailed information about this specific procedure, especially considering your highly respected position in the cosmetic and functional world of surgery.

Thank you for your attention to this matter. I hope my response was not off-putting.

What are you talking about? OP recognize that his nasion is also suboptimal position too much backward with the whole maxilla. 7mm underbite is a lot. And a normal LF2 can give better result in his case but this must be discussed with a pro. The quadrangular LF2 is some sort of less invasive than regular LF2 but only a little. In both cases cuts are made in the medial orbital wall region. Only difference is that regular LF2 also the nasion is cutted with the same cut were it's made on the medial orbit (both sides). It's not a challenging surgery in the right hands. Quadrangular LF2 can also achieve excellent results depending on the needs of the patient. Anyway Dr. Celai result is mediocre, he was hesitant to do a proper forward movement of the maxilla, then of course camouflaged with implants.
It would bother me having such big implants when going trough the airport scanner.

 

[Marelago]

There are definitely surgeons who do it. In America, they perform aesthetic OBOs on non-deformed people and that's more invasive than LF2.

1000x more get it in your heads. The surgeons where propose this on non deformed patients have no ethics. And many times it's not even the IPD that is off but other things in the face like projection etc.

 

[Marelago]

Yea but quadrangular L2 is if the nasal framework is normal and the infraorbital+lower maxilla is recessed. A normal Lefort 1 doesn’t go that far up. Most people including Ramieri don’t like doing that stuff cuz of complications.

Then Ramieri is not good enough for this surgery. When he refuse LF2 per se in patients with glaring underbites. I had already a feeling about him where his results are underwhelming.
A good old Moammerts or Sailer would do it without thinking twice. But they are out of business I think.

 

[Snicket]

C'mon 7mm underbite, you really think this can be fixed with implants? How you think the Implants will be adjusted on the maxilla, than the 7mm underprojection upper teeths is not solved.
OP you're spot on with regular LF2 (not quadrangular) don't listen to some laymen that would suggest implants or other stuff in your case.
I saw a great result from a maxfac (craniofacial surgeon) from Monza (Italy) maybe he can help you? Or Pagnoni and Raffaini. I think with 25k euro you can do it in Italy.

Spoke with Pagnoni. He was not prepared to do a high level osteotomy. Told me that it’s only done to patients with severe airway problems (I know this isn’t true). I don’t get the impression he does it all, since he even gave a guy with a 14mm underbite LF1.

My understanding is that Raffiani only does a subspinal Lefort but haven’t checked with him yet. The trouble is finding someone who is even experienced, in this kind of thing. Most won’t touch anything above the infraorbital foramen. They don’t know how to do it and know it’s less risky + commercially more viable to just stick to jaw surgery.

 

[Snicket]

Forget Obwegeser he's is very very expensive and conservative in operative approaches. Go to Italy instead.

He was a promising lead because the guy clearly does and is very experienced in high level osteotemies.

 

[Marelago]

Spoke with Pagnoni. He was not prepared to do a high level osteotomy. Told me that it’s only done to patients with severe airway problems (I know this isn’t true). I don’t get the impression he does it all, since he even gave a guy with a 14mm underbite LF1.

My understanding is that Raffiani only does a subspinal Lefort but haven’t checked with him yet. The trouble is finding someone who is ethical and most importantly experienced, in this kind of thing.

This I wasn't prepared about Pagnoni that he did only a lf1 in a patient with 14mm overbite. Maybe it worked don't know.
Raffaini has perfect eye for esthetic and hands down the best results in maxfacsurgery I saw so far. Ok not many men are listed but neverthless he seems the Michelangelo under his peers.
Look 7mm overbite is not so much (I exaggerated). Your problem will be by a regular Lf1 that your midface will look even flatter. I think Raffaini use lypophilled bones to augment the cheeks (maxilla), way superior than implants. Sailer did this too.

 

[Snicket]

This I wasn't prepared about Pagnoni that he did only a lf1 in a patient with 14mm overbite. Maybe it worked don't know.
Raffaini has perfect eye for esthetic and hands down the best results in maxfacsurgery I saw so far. Ok not many men are listed but neverthless he seems the Michelangelo under his peers.
Look 7mm overbite is not so much (I exaggerated). Your problem will be by a regular Lf1 that your midface will look even flatter. I think Raffaini use lypophilled bones to augment the cheeks (maxilla), way superior than implants. Sailer did this too.

I’m seeing Raffaini soon but I’m pretty confident he only does jaw surgery. I know that regular LF1 is a suboptimal solution for most class 3s - certainly my case. It’s frustrating because I have no downward growth either.

What I actually need is a high level osteotemy to advance the midface + bimax to get the optimal bite/ occlusal plane. But finding surgeons that do this has proven near impossible.

I’ve spoken to many surgeons. My big takeaway is that anything that doesn’t move the nation/ nasal cavity can be replicated with implants.

High LF1 and Quad LF2 are not particularly good. I was extremely disappointed by the results, having met patients who had these operations.

 

[Marelago]

Spoke to Obw. Told me I only needed an LF1 and refused to do anything else, insisting that the rest of the maxilla (minus the bite) was fine - contrary to the advice of every other maxilla facial surgeon I’ve spoken to.

He was a promising lead because the guy clearly does and is very experienced in high level osteotemies. look with one front and two side pictue

Obwegeser is not blackpilled. If he's right that he thinks you would be fine only with lf1 I can determine only with pics of your face. That the other surgeons thinks that you need lf2 to fix your aesthetic problem is not relevant. They don't refer you to a surgeon that would look at your case and decide if lf2 is needed. Proper assessment.
I can give you address of two swiss maxfacs (they work together and do also OBO, LF3) are highly regarded in the maxfacs community, they do also LF 2 on regular basis.

 

[Snicket]

I can give you address of two swiss maxfacs (they work together and do also OBO, LF3) are highly regarded in the maxfacs community, they do also LF 2 on regular basis.

Please DM me the names. No surgeon has recommended an LF2, they just acknowledged that the hypoplasia extended across the entire maxilla and was not just confined to the upper jaw. Obw claimed that my maxilla was properly developed, just not my upper jaw - quite incredibly. Which isn’t true in the majority of class 3s.

All other surgeons I’ve spoke to advised bimax + implants as an imperfect solution.

 

[Marelago]

Please DM me the names. No surgeon has recommended an LF2, they just acknowledged that the hypoplasia extended across the entire maxilla and was not just confined to the jaws.

Send some photos of your face first, the Swiss surgeons need this anyway to asses your case. Look at my expertise (other posts) I helped already others in this forum. I don't shoot names without knowing the case.

 

[Snicket]

Send some photos of your face first, the Swiss surgeons need this anyway to asses your case. Look at my expertise (other posts) I helped already other in this forum. I don't shoot names without knowing the case.

I don’t want to share my face on this site. I can provide a cephalogram and CT scan though. It captures my maxillary hypoplasia and preserves my privacy.

 

[Marelago]

I don’t want to share my face in this site. I can provide a cephalogram though. It captures my maxillary hypoplasia.

I respect that.