LeFort 2 / 3 -> Malar osteotomy

[Alue]

I don't know yet. 


I think I did see those papers, the quadrangle lefort looks amazing, just wish more surgeons would adopt this technique. 

[Lazlo]

I don't know yet. 


I think I did see those papers, the quadrangle lefort looks amazing, just wish more surgeons would adopt this technique.

you should show it to sinn and ask him to do it for you.

[Rico]

http://www.ncbi.nlm.nih.gov/pubmed/2708533

Check this abstract and look at names...

[PloskoPlus]

For example, he told me that in a few years a computer program will be used to simulate how braces will move and shift your teeth and will provide you with an exact image of how your teeth will look and this will give the orthodontist EXACT measurements for how to apply your braces!

SureSmile has been around for quite a while.  My ortho uses it, but I think only for very fine final adjustments (hasn't used it on me yet).

[Lazlo]

Rico that paper looks good. Is that better than the procedure which Zarrinibal does? If one of you could access the full paper we'd see some visual examples of the procedure.

Come on guys stop being so lazy and let's figure out what the best procedure for this is. You will not the orbital rim remains unchanged, so this is not as good it seems as the procedure Sinn did for Earl!!!!! But I'm not sure how much of the zygoma is advanced by sinn.

Honest'ly I think if you need this procedure and also the lefort 1 (which I do) then you need two fractures since the maxilla needs to be moved for your bite counterclockwise and lowered a bit, but for the cheekbones and orbital rim you probably need the complex raised a bit and projected forward. So I don't see how you can get the upper jaw and the cheekbones fixed with the same procedure. DO you guys agree? Well next week I'm contacting Sinn so I'll figure it out.

[PloskoPlus]

Honest'ly I think if you need this procedure and also the lefort 1 (which I do) then you need two fractures since the maxilla needs to be moved for your bite counterclockwise and lowered a bit, but for the cheekbones and orbital rim you probably need the complex raised a bit and projected forward. So I don't see how you can get the upper jaw and the cheekbones fixed with the same procedure. DO you guys agree? Well next week I'm contacting Sinn so I'll figure it out.

AFAIK, Obwegesser has done a combined Le Fort I + modified Le Fort III in a single operation (the blonde demon->angel girl).  His uncle - THE Obwegesser, did it first back in the 60s.

[Lazlo]

AFAIK, Obwegesser has done a combined Le Fort I + modified Le Fort III in a single operation (the blonde demon->angel girl).  His uncle - THE Obwegesser, did it first back in the 60s.

Yes Plosko, I think this is indeed the best operation. But didn't Rico said he spoke with Obswegesser and he said he wouldn't do it for him? I mean if this is an option it is certainly the perfect solution. I'd prefer not to have to travel to Europe, but if I could get it done with Sinn that would be great. I'll let you guys know. But yes, I agree with you 100 percent Plosko, it's the best solution for the problem. Anyone actually consult with him and know what he has to say?

[Gregor Samsa]

How can you tell that your orbital rims are deficient and that you need more than a zygomatic osteotomy?

I sent Obwegeser an e-mail about six months ago by the way but he never replied despite that I made it clear that I'm from Europe (since earl said that Obwegeser doesn't accept patients from North America).

[terry947]

@ gregor - If your orbital rims are deficient I think you'd have a negative eye tilt or you're eyes would kind of buldge. i think.

@lazlo - why would your maxilla need to be lowered?

[Gregor Samsa]

I haven't seen anyone here with bulging eyes but for some reason everyone seems convinced that they need to advance the orbital rims. I don't think my own eyes bulge but I do have a negative vector cheek.

[terry947]

ya same here I'm pretty sure I also have a negative vector cheek, keeps like my eyes are sort of un-supported (but a left 1 would also fix this no?).

[Gregor Samsa]

ya same here I'm pretty sure I also have a negative vector cheek, keeps like my eyes are sort of un-supported (but a left 1 would also fix this no?).

You mean a Le Fort I? If that's what you meant then the answer is unfortunately no; a Le Fort I does nothing to address deficiences under the eye. I'm hoping the zygomatic osteotomy is enough to correct it if you just have a negative vector cheek and no orbital rim deficiency though.

[terry947]

Yes I meant to say Le Fort I, also I fear I may need a similar procedure as some people here. My nose sticks out a lot but my side cheek bones are super flat, my eye actually protrudes more forward than my cheek bones. As if I have dysgnathia . The second guy on google images has a similar eye area as me. I dont want to self-diagnose myself, I guess I'll wait until I get a ceph....

[PloskoPlus]

How can you tell that your orbital rims are deficient and that you need more than a zygomatic osteotomy?

No idea.  My surgeon did say that under-eye flatness often comes with great facial width like mine.  Maybe he's right:

http://www.listal.com/viewimage/1018849h

This chick has eye bags in almost every photo... and she's a model.

[Lazlo]

@ gregor - If your orbital rims are deficient I think you'd have a negative eye tilt or you're eyes would kind of buldge. i think.

@lazlo - why would your maxilla need to be lowered?

for more teeth show.