Figured out what I dont like about my face.

[Eroica]

My midface is underdeveloped. I mean the part right below the eyes. My Maxillary dental arch is within the normal range.

What is the cause of this? And can it be fixed? I have a mild class one open bite. My sister has the same bite but has a normally developed midface.

Is plastic surgery my only answer to this, or is there an orthognathic procedure that can fix everything in one go?

Infraorbital rim implants.

http://www.dryaremchuk.com/english/infraorbital-rim-implants.htm

Your midface is not necessarily "underdeveloped" though, a recessed midface can be a naturally inherited trait.

[Heavyweight]

I think a high Lefort 1 osteotomy would be a good treatment for midface deficiency. Does anyone know of any surgeons who perform this?

[Eroica]

Many surgeons are skilled enough to perform the procedure, but good luck getting it done for cosmetic reasons alone without any kind of syndromal deformity. The risks are simply too high to perform the procedure unless absolutely necessary, i.e. in situations where the eyes are at risk because of the severity of the maxillary deficiency. The location of the cuts risks causing blindness, brain damage, and death.

[Heavyweight]

Many surgeons are skilled enough to perform the procedure, but good luck getting it done for cosmetic reasons alone without any kind of syndromal deformity. The risks are simply too high to perform the procedure unless absolutely necessary, i.e. in situations where the eyes are at risk because of the severity of the maxillary deficiency. The location of the cuts risks causing blindness, brain damage, and death.

Are you thinking of the Lefort 3? The high Lefort 1 seems relatively straightforward.

[Eroica]

Blindness has been reported numerous times in high lefort I osteotomies.

I should also mention that the high lefort I won't fix the orbital rim deficiency, the cuts aren't high enough.

[Heavyweight]

Blindness has been reported numerous times in high lefort I osteotomies.

I should also mention that the high lefort I won't fix the orbital rim deficiency, the cuts aren't high enough.

You are right. I just did a bit more research and found the same thing.

Do you think zygomatic osteotomies are similarly risky? I know Mommaerts performs these.

[neferkitti]

Do you think zygomatic osteotomies are similarly risky? I know Mommaerts performs these.

Zygomatic osteotomies seem pretty invasive, from my quick read around the net. Apparently, the surgeon needs to go through the mouth and the lower lid (??). Is that right? What does this doctor have to say about it?

[Eroica]

Blindness can be a risk in modified zygomatic osteotomies where the whole cheekbone structure (including the malar and orbital rim) is advanced. I don't think it's a serious concern in a standard malar osteotomy (as performed by Mommaerts) where they simply advance a small wedge of the malar bones.

Incisions through the the lower eyelid are standard fare in plastic and maxillofacial surgery. Nothing to be too concerned about.