Which surgeons do midface advancement surgery?

[Mark505]

title.

[Gregor Samsa]

What you're looking for is a procecure called Le Fort III and very few surgeons have a lot of experience doing them and most of them refuse to do it on non-syndrome patients. earl25 on this forum basically contacted all the maxfac surgeons in the world who have experience doing the Le Fort III and he ended up having a modified Le Fort III with dr Sinn in the US.

There are alternatives depending on what you need done. Paranasal augmentation with HA or similar can bring out the lower part of the midface but I personally hate the result I got from that procedure. Zygomatic osteotomies may or may not be able to address issues in the eye area and immediately below it (the jury is still out on that one).

Based on what I've seen so far, it unfortunately looks like midface deficiences are one of the hardest cosmetical issues to fix.

[Gregor Samsa]

Have you seen any results from zygomatic osteotomies?

[Gregor Samsa]

not that I would know. Talking about zygomatic sandwich procedure or something like that?

Yes, something like that (I don't know what exactly). It's still not clear if you can get anterior projection from a zygomatic osteotomy or not and I haven't seen any before/after pictures.

[Gregor Samsa]

If your midface is underdeveloped then you want it to come forward, i.e. get more anterior projection. Some people claim that zygomatic osteotomies can only give you lateral projection, i.e. widening your face.

[Rico]

I also haven't found yet.  I'm waiting for some more detailed answers from a few surgeons.
Generally every surgeon who can make any procedures in my case in SAFE WAY, probably will ba able to do LeFort3

Within 2 weeks I will known some names (if any)
 I will inform You if find

[Lazlo]

I also haven't found yet.  I'm waiting for some more detailed answers from a few surgeons.
Generally every surgeon who can make any procedures in ma case in SAFE WAY, probably will ba able to do LeFort3

Within 2 weeks I will known some names (if any)
 I will inform You if find

cool thanks.

[earl25]

very fed surgeons do a lefort iii. very very very very few surgeons will do it on a non syndrome person

[PloskoPlus]

very fed surgeons do a lefort iii. very very very very few surgeons will do it on a non syndrome person

Are you happy with your results? How's the swelling?

[Lazlo]

i know schendel will do it, dr. douglas sinn will do it, and dr. eugene keller at the mayo clinic.  Probably Keller has the most experience with it. But sounds like earl had good results with Sinn. That's probably about it in North America.

the german surgeons we know do that as well as chin-wing osteotomy. but never really seen a real result of the chin wing itnerestingly.

Here's basically what we are all talking about. It's a little paper about the "beauty arch" what they basically mean is a positive vector under the eye. Essentially what we're talking about here, anterior projection (i.e. forward) of the upper cheekbone/zygoma/orbital rim. These surgeons however, produced the result as you will read through IMPLANTS, the lefort 1 did not advance the "midface" or as we are saying the cheekbones.

 http://www.aicef-chirurgiaplasticafacciale.it/contiene_i_PDF_e_allegati/Beauty%20Arch%20Concorso%20AICEF%20Marianetti.pdf

[Lazlo]

READ THE ARTICLE!!!! AND READ THE OTHER THREADS ON THIS BOARD BEFORE ASKING STUPID QUESTIONS AND REPEATING WHAT HAS ALREADY BEEN WRITTEN ELSEWHERE.


FROM THE ARTICLE, READ THIS:

A limit of our Beauty Arch is to focus it on the analysis of the profile, without allowing the
assessment of the transversal measure of the zygomatic region in frontal plane.
In Literature several techniques of malar augmentation have been described and classified into two
groups: osteotomic techniques and grafts placements.
The former include: 1) the "Lamellar split osteotomy" described by Salyer KE (10) with the purpose
of obtaining an antero-lateral augmentation of the cheekbone; 2) the Zigomatic Sagittal Split
Osteotomy or ZSSO described by Gasparini et al.(11) that allows for correction and stabilization of
the midface without the use of distraction devices; 3) Sandwich Zygomatic Osteotomy introduced by
Mommaerts et al.(12), which consists in the anterior and lateral dislocation of the zygomatic bone
after the vertical and oblique-horizontal osteotomy, 4) Le Fort III Advancement of the midface (13),
which has been widely codified and has been applied for decades to correct the hypoplasia of the
middle third of the face. However, it implies the movement of the median nasal region, which
sometimes is not necessary in patients affected by non-syndromic malformation. In addition, the
invasiveness of the technique restricts its application to patients with severe hypoplasia.
Among the techniques exploiting the use of grafts, several autologous, heterologous and alloplastic
materials to increase the projection of the zygomatic region have been proposed. Silicon, Proplast
and Supramed (15,16,18,23) do not represent good choices because of their frequent complications such
as: formation of foreign body granulomas, displacement of the implant, and post-operative infective complications.
Autologous bone graft is an excellent material, but has the not negligible drawback of the donor site
morbidity. In our study we have used Medpor implants of different size depending on the
characteristics of the zygomatic hypoplasia. Medpor has proven to be a highly biocompatible
material. Futhermore, the firm nature of this material allows a simple modeling and adaptation to
the underlying tissues. Because of the white color, Medpor implants are not visible through the
overlying tissue; the surface is rough in order to facilitate its anchoring to the tissue in the desired
position.
T

[Lazlo]

By the way, Schendel told me avoid Mommaerts as his results, he said, were unpredictable regarding the zygomatic advancement. The only person who we know who has had this procedure done successfuly is earl and that was with dr. sinn, and i don't really know which of the several osteotomy techniques for the orbital rim/zygomatic complex was done.

By the way it's PROBABLY INACCURATE YOU MORONS to calls it a modified LEFORT III since as this f**kING article states lefort III's also mobilize the nasal region.

All of you are so goddamn stupid it blows my mind.

[PloskoPlus]

Lazlo,

Are you class ii or class iii?

[notrain]

Lazlo,

Are you class ii or class iii?

he has a class 2 jaw and a class 3 temper.

[falcao]

I'm not surprised your article is Italian. In Spain and Italy when you go for an orthognathic surgery, in most cases they will discuss what implants can do for you - e.g. gonial angle, paranasal or malar . Medpor seems to be the most common choice among maxillofacial surgeons there - I've been offered these three times. I like the fact that they take a holistic approach. From all the consultations I've had there, this is the NORM. I think many people can greatly benefit from implants and I'm not implant averse.You need to get it right though - type, size, placement. Many people get the wrong type and size or an idiot surgeon to place them and then complain how bad implants are. Others do everything right and still develop nasty complications. It's all just a big gamble, like everything else.

By the way, I'm not surprised either that your study looked at 74 WOMEN. I think the male and female aesthetics in the mid-face is TOTALLY different, one of the areas that define you strongly as a male or female and define you strongly as ugly or good looking.