lefort i + midface implants for middle third dimo and projection

[xlefort]

i have weak inframalar support and a class 3 recessed maxilla that's a bit flat and fucks my middle third dimo and gives a flat profile. this is because i am part east asian and have had poor breathing habits growing up.

can i get a lefort i to advance my premaxilla, then get additional implants for the rest of my maxilla to improve support and overall projection? infraorbital implants for under eye support and upper projection which will make 3/4 zygos look better/reduce undereye hollowing and then paranasal (pyriform aperture) implants to fix sunken nose and midface hollowing? would this not aesthetically replicate the effects of a lefort ii but with just better control over final result because of displaced geometry through implants?

 

[jailcel]

when u even consider a lefort 1 its over

 

[xlefort]

when u even consider a lefort 1 its over

such helpful input

 

[mohito]

Not exactly. Le fort ii does more than just push the premaxilla forward, it changes how the mandible occludes too. What ur describing can improve projection and infraorbital/paranasal support, but it wont replicate the aesthetic effects of a true le fort ii.
To really do that, you’d need le fort i plus bsso (for the mandible)

Make sure to mark this post as solution, just click the check mark on my right

 

[jailcel]

you’d need le fort i plus bsso

bsso saves lives

 

[xlefort]

Not exactly. Le fort ii does more than just push the premaxilla forward, it changes how the mandible occludes too. What ur describing can improve projection and infraorbital/paranasal support, but it wont replicate the aesthetic effects of a true le fort ii.
To really do that, you’d need le fort i plus bsso (for the mandible)

Make sure to mark this post as solution, just click the check mark on my right

thanks for this response, sounds pretty much right but i'd like some more elaboration on what you mean by lefort ii post-op maxilla's relationship with the occluded mandible.

What ur describing can improve projection and infraorbital/paranasal support

yes, this is all i want and need, my maxilla is not terribly recessed by most metrics, just flat especially relating to my prognathic mandible.

 

[mohito]

i'd like some more elaboration on what you mean by lefort ii post-op maxilla's relationship with the occluded mandible

Absolutely.
When the upper jaw moves forward (in le fort ii), the bite relationship changes automatically because your mandible has to meet the upper teeth in a new position.
The upper teeth come forward, the mandible is shifted to re establish contact. That means that the way the teeth fit together (occlusion) changes and chin position can look different because of that rotation.

I would appreciate if u mark my post as solution now

 

[xlefort]

I would appreciate if u mark my post as solution now

yup, already did

When the upper jaw moves forward (in le fort ii), the bite relationship changes automatically because your mandible has to meet the upper teeth in a new position.
The upper teeth come forward, the mandible is shifted to re establish contact. That means that the way the teeth fit together (occlusion) changes and chin position can look different because of that rotation.

so disregarding the logistics of it all you're essentially saying the mandible actually advances itself to compensate for the added maxillary projection? or is it just the lower teeth that change in position

 

[xlefort]

it wont replicate the aesthetic effects of a true le fort ii.
To really do that, you’d need le fort i plus bsso (for the mandible)

but wouldn't bsso+lefort i (which is just djs) be different from lefort ii

 

[mohito]

all you're essentially saying the mandible actually advances itself to compensate for the added maxillary projection?

Yes, mandible is advanced to match the new position.

Btw to mark solution you have to click this check mark (its not the upvote). Thx in advance

 

[mohito]

but wouldn't bsso+lefort i (which is just djs) be different from lefort ii

Its not the same since le fort ii moves a larger midface segment and not just jaws, but if u do both le fort i and bsso you would get the similar result since both upper and lower jaw is repositioned

 

[xlefort]

Its not the same since le fort ii moves a larger midface segment and not just jaws, but if u do both le fort i and bsso you would get the similar result since both upper and lower jaw is repositioned

but not really because my midface wouldn't have that much of a change, just in my premaxilla

 

[mohito]

but not really because my midface wouldn't have that much of a change, just in my premaxilla

If thats the case then lefort i is sufficient since it addresses the maxilla

Btw you're still just upvoting my posts, as i said mark solution by clicking the check mark on my right, not the upvote. Sorry if i'm explaining too much

 

[xlefort]

If thats the case then lefort i is sufficient since it addresses the maxilla

Btw you're still just upvoting my posts, as i said mark solution by clicking the check mark on my right, not the upvote. Sorry if i'm explaining too much

alr i marked solution and yeah no worries

also lefort i is not sufficient because it only advances the aforementioned premaxilla meaning my frontal zygos and infras along with the rest of my middle/upper midface will remain unaffected

 

[mohito]

alr i marked solution and yeah no worries

also lefort i is not sufficient because it only advances the aforementioned premaxilla meaning my frontal zygos and infras along with the rest of my middle/upper midface will remain unaffected

Thx

I think i get what you’re saying now. If your concern is midface deficiency, then le fort ii can fix that and le fort ii does advance the infraorbital rims to some degree, but it is not significant, and it has no meaningful effect on zygos and frontal.
For that purpose, you'd need a le fort ii combined with targeted augmentation of the zygos, infraorbital rim, and frontal regions using custom implants

 

[xlefort]

Thx

I think i get what you’re saying now. If your concern is midface deficiency, then le fort ii can fix that and le fort ii does advance the infraorbital rims to some degree, but it is not significant, and it has no meaningful effect on zygos and frontal.
For that purpose, you'd need a le fort ii combined with targeted augmentation of the zygos, infraorbital rim, and frontal regions using custom implants

yeah exactly, the only thing is there's no way in hell im getting lefort ii with it's 12% mortality rate and general risk on top of the fact that it would only be cosmetically performed
no reliable maxfac surgeon is giving me lefort ii in this lifetime lol

 

[xlefort]

that's why i was thinking of lefort i + inframalar implants + pyriform aperture implants and then fat grafting as a final touch if needed

 

[mohito]

yeah exactly, the only thing is there's no way in hell im getting lefort ii with it's 12% mortality rate and general risk on top of the fact that it would only be cosmetically performed
no reliable maxfac surgeon is giving me lefort ii in this lifetime lol

Yeah, you know if i were in your place, i would get a le fort i and infraorbital rim implants and call it a day

 

[xlefort]

Yeah, you know if i were in your place, i would get a le fort i and infraorbital rim implants and call it a day

okay fire can you look at my newest thread for more info, i can mark your post as solution