Author Topic: I had modified lefort iii  (Read 134868 times)

meepmeepmeep

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Re: I had modified lefort iii
« Reply #225 on: February 10, 2016, 11:00:27 AM »
Can you still get some cheek augment after a mod L3, like say a small custom implant or fillers?

If you can get custom jaw implants after bsso (I've been told by respected surgeons you can) then there should be no reason why not.

molestrip

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Re: I had modified lefort iii
« Reply #226 on: February 10, 2016, 09:09:11 PM »
Turvey recently published a paper on 13 patients who had modified LeFort 3. That's still not a lot of course but another surgeon to consider if interested.

Schrödingers Jaw

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Re: I had modified lefort iii
« Reply #227 on: February 11, 2016, 02:37:42 PM »
If you can get custom jaw implants after bsso (I've been told by respected surgeons you can) then there should be no reason why not.

I was thinking since the zygomatic bone is (partly) mobilized and moved. It might be problematic to insert an implant or perform another osteotomy on that bone a second time.

meepmeepmeep

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Re: I had modified lefort iii
« Reply #228 on: February 11, 2016, 02:52:24 PM »
I was thinking since the zygomatic bone is (partly) mobilized and moved. It might be problematic to insert an implant or perform another osteotomy on that bone a second time.

i see what you are saying. I'm not sure about a second osteotomy but i think an implant or fillers after a mod lefort 3 is possible for sure. it is really only a small section of the zygomatic arch that is mobilized in a mod lefort 3 as far as i know. the cut is made maybe less than a cm past the malar prominence on the zygomatic area. the whole arch or generally even the majority of the arch isn't mobilized because the amount of muscles (strong muscles at that) that attach to the zygomatic arch. or at least this is what I've been told. so there will be a slight step off between the back of the malar prominence and the zygomatic arch where advancement was made. which i guess means that a custom implant would just have to account for that step off or for however that step off heals. apparently they can smooth themselves out to a degree.


JawSurgery2016

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Re: I had modified lefort iii
« Reply #229 on: March 28, 2017, 12:54:33 AM »
Are you referring to Dr. Douglas Sinn in Dallas?

JawSurgery2016

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Re: I had modified lefort iii
« Reply #230 on: March 28, 2017, 12:56:06 AM »
yes

Sorry, forgot to quote what you said. You responded that Dr. Sinn did your surgery, but I'm wondering if you mean Dr. Douglas Sinn in Dallas. If so, I may want to reach out to him for my case. I have a very depressed mid face that cheek implants didn't really help at all. Also very weak orbital area. If you recommend him, I'll give him a call.

beyondconfusedtbh

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Re: I had modified lefort iii
« Reply #231 on: February 07, 2019, 11:23:36 AM »
Sorry to revive this topic. Earl I'm not sure if you got my email but I'm just wondering, where were your problem areas for swelling? Did the swelling in your upper eyelids last long? Thanks.

Lazlo

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Re: I had modified lefort iii
« Reply #232 on: February 07, 2019, 01:20:07 PM »
Sorry to revive this topic. Earl I'm not sure if you got my email but I'm just wondering, where were your problem areas for swelling? Did the swelling in your upper eyelids last long? Thanks.

I know from talking to various patients this is a very mild operation as far as recovery is concerned. Most people look fine and are back to work in two weeks.

earl25

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Re: I had modified lefort iii
« Reply #233 on: February 09, 2019, 04:39:01 PM »
Sorry to revive this topic. Earl I'm not sure if you got my email but I'm just wondering, where were your problem areas for swelling? Did the swelling in your upper eyelids last long? Thanks.

I replied to your email. Check your spam folder

beyondconfusedtbh

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Re: I had modified lefort iii
« Reply #234 on: February 10, 2019, 06:00:37 AM »
I replied to your email. Check your spam folder

Nothing, try pming.

scramfranklin

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Re: I had modified lefort iii
« Reply #235 on: February 12, 2019, 06:10:22 AM »
Earl,

I'll be getting jaw surgery in the future. After that, I was planning on doing custom midface implants rather than a modified lefort iii. I don't need it, but it would help my aesthetics. Do you agree that a similar outcome can be gotten from implants? This is what Eppley has to say about it:

"Q: Dr. Eppley, Since you’re a maxillofacial surgeon, you know about the LeFort III Osteotomy that is done in cases of severe midfacial hypoplasia where the patient usually suffers from a syndrome like Crouzon’s.

However, many say that such a procedure,although extremely invasive and dangerous in some cases, could theoretically improve the appearance of a non-deformed patient dramatically.

Since almost no maxillofacial surgeons would perform this osteotomy on patients that have no bite or jaw problems, are there any cosmetic operations that can be done on a non-syndrome patient and replicate the aesthetic outcomes of a Lefort III osteotomy?

A: The effects of a LeFort III osteotomy are to bring forth the lower orbital rim, nose bridge and base and maxilla. This type of change can be replicated by a custom only implant placed over the exact same facial areas. While previously not possible, the use of custom implant design from a 3D CT scan make possible a midface implant that can essentially replicate what a LeFort III osteotomy can do. (minus the occlusal changes) I have made several of these midface implant designs recently and they are inserted through an intraoral incisional approach. Only the augmentation of the nose needs to be done separately through a closed rhinoplasty approach.

Dr. Barry Eppley"


beyondconfusedtbh

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Re: I had modified lefort iii
« Reply #236 on: February 12, 2019, 02:42:20 PM »
Earl,

I'll be getting jaw surgery in the future. After that, I was planning on doing custom midface implants rather than a modified lefort iii. I don't need it, but it would help my aesthetics. Do you agree that a similar outcome can be gotten from implants? This is what Eppley has to say about it:

"Q: Dr. Eppley, Since you’re a maxillofacial surgeon, you know about the LeFort III Osteotomy that is done in cases of severe midfacial hypoplasia where the patient usually suffers from a syndrome like Crouzon’s.

However, many say that such a procedure,although extremely invasive and dangerous in some cases, could theoretically improve the appearance of a non-deformed patient dramatically.

Since almost no maxillofacial surgeons would perform this osteotomy on patients that have no bite or jaw problems, are there any cosmetic operations that can be done on a non-syndrome patient and replicate the aesthetic outcomes of a Lefort III osteotomy?

A: The effects of a LeFort III osteotomy are to bring forth the lower orbital rim, nose bridge and base and maxilla. This type of change can be replicated by a custom only implant placed over the exact same facial areas. While previously not possible, the use of custom implant design from a 3D CT scan make possible a midface implant that can essentially replicate what a LeFort III osteotomy can do. (minus the occlusal changes) I have made several of these midface implant designs recently and they are inserted through an intraoral incisional approach. Only the augmentation of the nose needs to be done separately through a closed rhinoplasty approach.

Dr. Barry Eppley"


There's a handful of surgeons that will perform what you're calling a 'modified lefort iii'. It is not as invasive as a traditional Lefort III.

To answer your question though, I guess implants can probably replicate the effect. Weigh up the pros & cons before making your decision.



Lonamiam

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Re: I had modified lefort iii
« Reply #237 on: February 25, 2019, 07:32:17 AM »
Hi Earl
Did you notice any difference in nasolabial folds?

ODog

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Re: I had modified lefort iii
« Reply #238 on: April 04, 2019, 09:26:03 PM »
I imagine this procedure to basically be a guarantee to produce dry eye syndrome. Incision along the eyelid will cause so much inflammation and disrupt tear flow/ oil secretion of the glands. I can’t see how this could not be the case and might lead to severe problems down the road.

There is no cure for dry eye and it is a living hell living with it.

micjawsurgery

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Re: I had modified lefort iii
« Reply #239 on: April 17, 2019, 01:37:08 PM »
Hey Earl, any side effects 6 years later? reading your posts it seems like your existing asymmetry became more noticeable?