Le Fort I height and facial "angularity"

[PloskoPlus]

Surgery next week.  Originally my surgeon said he'd cut a bit higher "to fill out the face".  4 months ago, seeing my much leaner face, he said normal Le Fort I to maintain the angularity.  A couple of weeks ago he again said just a bit higher than a normal Le Fort I.  According to him "normal" is just above the teeth roots.  "Slightly higher" - 1 to 2 mm above normal.  What the hell does it mean?  (Addressed especially to those who've seen my mug in the private forum).

[Gregor Samsa]

I still don't understand why you think a zygomatic osteotomy won't work for you? Is it because your face will end up too wide?

[PloskoPlus]

I still don't understand why you think a zygomatic osteotomy won't work for you? Is it because your face will end up too wide?

Yes.  The crappy phone camera selfies in the private forum make my face narrower than it really is.

[Modigliani]

Can ZO not be performed purely to increase anterior projection?

[PloskoPlus]

Can ZO not be performed purely to increase anterior projection?

I don't quite understand the mechanics of ZO.  My surgeon talks in terms of "hinging out", so a lateral component seems unavoidable.

[Optimistic]

I don't quite understand the mechanics of ZO.  My surgeon talks in terms of "hinging out", so a lateral component seems unavoidable.

I think in this case simply using bio-oss / HA paste would be one way of getting lateral projection without the added width.

[Modigliani]

Or even just a tradition silicone implant.

[PloskoPlus]

My surgeon told me that width and flatness just below the eyes often come in a package.

[Modigliani]

Ugh, always a bloody trade off with all these fixes 

[LoveofScotch]

I just have a hard time imagining how cutting 1-2mm "slightly higher" up would produce a negative aesthetic result.

What are your thoughts, PP?

[ticktickatick]

From this picture it looks like standard lefort 1 at the teeth roots is right before you hit the nose. Do you have extra space there for them to cut without...cutting into your nasal area?

[Alue]

Does doing a higher lefort I make "the pig nose effect" (aka nose looking upturned after forward movement) after surgery worse or does it make pig nose effect less noticeable? If I ever have le fort I to move my jaw forward, I worry about the nose because to me, my nose is great the way it is in terms of size, projection and nostril width/shape. I am afraid of doing anything such as shaving down the anterior nasal spine or alar cinch.

I worry about the same thing.  I think widening of the nose is common, as far as upturn, maybe slightly but depends on the amount of advancement. 

[PloskoPlus]

I just have a hard time imagining how cutting 1-2mm "slightly higher" up would produce a negative aesthetic result.

What are your thoughts, PP?

Surgeon: higher Le Fort fills out the face, normal Le Fort - face more angular.  Dunno.

[PloskoPlus]

From this picture it looks like standard lefort 1 at the teeth roots is right before you hit the nose. Do you have extra space there for them to cut without...cutting into your nasal area?

Well my upper lip is exactly average length or 1 mm shorter than average, I forget.  But my face is big - width and length.

[PloskoPlus]

I wonder if i were to have 5 mm advancement if i could get away with not doing anything to my nose? I think in any case, i would probably just leave my nose alone and see how it looks after surgery( that is if i'm having surgery, ==>>whole other story).

So IF the result turned out to be too upturned/piggy, then i would just go for a nose job later because i am against the idea of nasal bone shaving and alar cinch during jaw surgery. I have a small nose (I am asian) and I do not like the idea of removing any bone from my nose.

I don't think it's a good idea to micromanage the surgeon.  Theoretically he should know better.  Find a good surgeon and trust his aesthetic sense to do the right thing.

(I wish I could operate on myself, but I can't).