Author Topic: SARPE v. segmental le fort 1?  (Read 1364 times)

The Quest for Aesthetics

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SARPE v. segmental le fort 1?
« on: February 12, 2017, 07:26:01 AM »
Am I right in saying that the principle advantage of SARPE over segmental le fort 1 for maxillary widening is the amount of widening obtainable? Do either of these procedures differ in the quantity of maxilla (vertically speaking) that can potentially be mobilised for this widening? Essentially I'm looking to broaden as much of the midface as possible, which extends beyond the dentoalveolar part of the maxilla.

Any comments/knowledge will be appreciated
« Last Edit: February 12, 2017, 08:09:13 AM by The Quest for Aesthetics »

Wheatsnax

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Re: SARPE v. segmental le fort 1?
« Reply #1 on: February 12, 2017, 11:49:48 PM »
Asked around and the answer is no for adults, yes in those still growing

I was also hoping to broaden my upper midface

Lazlo

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Re: SARPE v. segmental le fort 1?
« Reply #2 on: February 13, 2017, 12:33:45 AM »
Am I right in saying that the principle advantage of SARPE over segmental le fort 1 for maxillary widening is the amount of widening obtainable? Do either of these procedures differ in the quantity of maxilla (vertically speaking) that can potentially be mobilised for this widening? Essentially I'm looking to broaden as much of the midface as possible, which extends beyond the dentoalveolar part of the maxilla.

Any comments/knowledge will be appreciated

you can do it --SARPE ---that is, segmental won't make any difference in looks

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #3 on: February 13, 2017, 02:28:53 AM »
you can do it --SARPE ---that is, segmental won't make any difference in looks

Why is this? Is it purely because just not enough widening can be achieved with it?

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #4 on: February 13, 2017, 02:30:30 AM »
Asked around and the answer is no for adults, yes in those still growing

I was also hoping to broaden my upper midface

Sorry could you expand on that please?

David_D

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Re: SARPE v. segmental le fort 1?
« Reply #5 on: February 13, 2017, 07:29:39 AM »
Am I right in saying that the principle advantage of SARPE over segmental le fort 1 for maxillary widening is the amount of widening obtainable? Do either of these procedures differ in the quantity of maxilla (vertically speaking) that can potentially be mobilised for this widening? Essentially I'm looking to broaden as much of the midface as possible, which extends beyond the dentoalveolar part of the maxilla.

Any comments/knowledge will be appreciated

My understanding is that SARPE uses the some type of bone incision as a single segment Lefort. Dr. Gunson told me that he could achieve any expansion he wanted to multi-segment Lefort and mentioned "centimeter." I don't have the impression he ever thinks SARPE is preferable - I could be wrong about that.

I don't see why a four segment Lefort cannot achieve good posterior and anterior expansion.

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #6 on: February 13, 2017, 07:34:10 AM »
My understanding is that SARPE uses the some type of bone incision as a single segment Lefort. Dr. Gunson told me that he could achieve any expansion he wanted to multi-segment Lefort and mentioned "centimeter." I don't have the impression he ever thinks SARPE is preferable - I could be wrong about that.

I don't see why a four segment Lefort cannot achieve good posterior and anterior expansion.

Now this is interesting. I'm going to see dr Gunson in June so I will mention this. @Lazlo would you be able to add anything here?

David_D

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Re: SARPE v. segmental le fort 1?
« Reply #7 on: February 13, 2017, 10:05:10 AM »
Now this is interesting. I'm going to see dr Gunson in June so I will mention this. @Lazlo would you be able to add anything here?

I was very focused on this question of SARPE vs. multi-segment Lefort.  Initially, I was pretty convinced that SARPE would be required to to get the anterior expansion that I wanted, including reducing the conical shape of the arch form.  I now think that a four-piece Lefort can likely do what I want it to do, which includes having more lateral tooth show, and minimal buccal corridors.  I'm scheduled with Dr. Gunson later this year.

Wheatsnax

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Re: SARPE v. segmental le fort 1?
« Reply #8 on: February 13, 2017, 11:41:07 AM »
Sorry could you expand on that please?

Sorry I meant it would only affect the dentoalveolar level in adults!

PloskoPlus

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Re: SARPE v. segmental le fort 1?
« Reply #9 on: February 13, 2017, 11:41:29 AM »
These surgeries expend the arch and nothing else. And it has to match the lower one - so only done when the lower is wider.

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #10 on: February 13, 2017, 12:01:05 PM »
These surgeries expend the arch and nothing else. And it has to match the lower one - so only done when the lower is wider.

Are we sure that these are true parameters, or rather that this is the way the procedure is almost exclusively carried out?

buzzhead

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Re: SARPE v. segmental le fort 1?
« Reply #11 on: February 13, 2017, 03:19:24 PM »
I had my maxilla brought forward 9 mm, down 5mm and widened 4mm with le fort 1.

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #12 on: February 13, 2017, 05:13:08 PM »
I had my maxilla brought forward 9 mm, down 5mm and widened 4mm with le fort 1.

Did your surgeon mention anything more about the widening? For instance did he imply that more was possible?

Lazlo

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Re: SARPE v. segmental le fort 1?
« Reply #13 on: February 14, 2017, 02:02:55 AM »
Gunson said he can widen 1cm????


So as you know how much you can widen maxilla is dependent on how wide your mandible is (which only like Dr. Li actually practices expanding). I've heard the upper limit of independent multi-seg lefort 1 is 7mm and it usually relapses 4mm so you only get like 3-4mm. I don't feel much if any wider after my lefort.

1cm you would feel. It would probably be AMAZING. But I've only heard SARPE can do that. Oh and it would DEFINITELY make your cheekbones wider since they're connected to the maxillary bone/complex. If you can get 1cm from gunson do it.

The Quest for Aesthetics

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Re: SARPE v. segmental le fort 1?
« Reply #14 on: February 15, 2017, 08:44:45 AM »
Gunson said he can widen 1cm????


So as you know how much you can widen maxilla is dependent on how wide your mandible is (which only like Dr. Li actually practices expanding). I've heard the upper limit of independent multi-seg lefort 1 is 7mm and it usually relapses 4mm so you only get like 3-4mm. I don't feel much if any wider after my lefort.

1cm you would feel. It would probably be AMAZING. But I've only heard SARPE can do that. Oh and it would DEFINITELY make your cheekbones wider since they're connected to the maxillary bone/complex. If you can get 1cm from gunson do it.

Lazlo how can we be certain that the zygoma will move outward with the mobilise maxillary segment? I mean the zygoma' attached to other parts of the midface that aren't mobilised so surely it's a bit far fetched to suppose that it would move in that way?

I will enquire about the multi segmental le fort with Gunson. I wonder no surgeon mobilises the lower palate? I'm assuming it's because the cut would be in a completely different place on the mandible to a standard BSSO, but why aren't surgeons comfortable making two separate cuts?