New Photos of Modified LeFort III

[CuriousDonut]

Hey guys I've read all there is about MLIII on this forum and that doesn't entail much, anyhow as an Australian I was quite shocked to come across the following attached PDF in an Australian maxfac journal, thinking that this procedure would be out of the realm for the surgeons here.
 
It is visibly apparent the drastic effects a MLIII has on a negative orbital vector and recessed zygomatic process, the female patients flat cheekbones become prominent afterwards.

[CuriousDonut]

2/2

[CuriousDonut]

cant attach pdf its too big, head over to academia.org and search for

The modified Le Fort I11 osteotomy in the correction of mid-facial deficiency.
Andrew A. C. Heggie, MDSc, LDS, MB BS, FRACDS, FFDRCSI, FRACDS(OMS)* Denise M. Lawry, MDSc, LDS, FRACDSt
M. Kevin Ruljancich, MDSc, LDS, FDSRCS*

and request a copy for yourselves.

hope I helped

[CuriousDonut]

Just in case anyones wondering I've contacted the author of the article, a surgeon working at Melbourne Oral & Facial Surgery here in Australia and have requested a consultation. Will keep thread updated.

http://www.mofs.com.au/

[Lestat]

Just in case anyones wondering I've contacted the author of the article, a surgeon working at Melbourne Oral & Facial Surgery here in Australia and have requested a consultation. Will keep thread updated.

http://www.mofs.com.au/

Thanks for the infos and photos!

Please let us know what the surgeon means, how dangerous such an operation is, how stable and whether he performs it on patients without syndrome (from a purely aesthetic point of view).

[ditterbo]

How are these modified, they look pretty traditional from my view.  Their entire middle face is flat, including their nose.  This doesn't look like what Sinn does in a mf lf 3, from what I recall reading people's descriptions of the cut.

[kavan]

How are these modified, they look pretty traditional from my view.  Their entire middle face is flat, including their nose.  This doesn't look like what Sinn does in a mf lf 3, from what I recall reading people's descriptions of the cut.

Correct. Just because the L3 is modified does not really convey HOW it's modified.

[CuriousDonut]

How are these modified, they look pretty traditional from my view.  Their entire middle face is flat, including their nose.  This doesn't look like what Sinn does in a mf lf 3, from what I recall reading people's descriptions of the cut.

Correct. Just because the L3 is modified does not really convey HOW it's modified.

And? Surgeon and article refers to it as MLIII ergo I refer to it as MLIII.

From the article: The modified Le Fort Ill osteotomy enables correctionof mid-face hypoplasiawhere the maxillary hypoplasia is associated with infraorbital and zygomatic deficiency

Thanks for the infos and photos!

Please let us know what the surgeon means, how dangerous such an operation is, how stable and whether he performs it on patients without syndrome (from a purely aesthetic point of view).

I will get back to you on it

[CuriousDonut]

Thanks for the infos and photos!

Please let us know what the surgeon means, how dangerous such an operation is, how stable and whether he performs it on patients without syndrome (from a purely aesthetic point of view).

Also I should not that both patients in that article are non-syndrome patients

[PloskoPlus]

It is a modified lf3, but the upper midface is barely improved. Most of the perceived improvement is from the LF1 level movement. The woman still had scleral show

[CuriousDonut]

It is a modified lf3, but the upper midface is barely improved. Most of the perceived improvement is from the LF1 level movement. The woman still had scleral show

be that as it may, there is an undeniably tremendous improvement in the zygomatic area

[Bowie]

It is a modified lf3, but the upper midface is barely improved. Most of the perceived improvement is from the LF1 level movement. The woman still had scleral show

Her scleral show looks WORSE after.

[CuriousDonut]

I have recessed orbits/zygomas yet have ZERO scleral show, a MLIII as seen in the article would greatly benefit me as the whole idea is to advance the area not raise it vertically...

The surgery did what it was supposed to do in both patients.

[kavan]

cant attach pdf its too big, head over to academia.org and search for

The modified Le Fort I11 osteotomy in the correction of mid-facial deficiency.
Andrew A. C. Heggie, MDSc, LDS, MB BS, FRACDS, FFDRCSI, FRACDS(OMS)* Denise M. Lawry, MDSc, LDS, FRACDSt
M. Kevin Ruljancich, MDSc, LDS, FDSRCS*

and request a copy for yourselves.

hope I helped

Just so you know, the surgical article is NOT found by going to 'academia.ORG'.   The link to article is here: (academia.EDU) http://www.academia.edu/27145374/The_modified_Le_Fort_III_osteotomy_in_the_correction_of_mid-facial_deficiency._Case_reports

[kavan]

Her scleral show looks WORSE after.

Yes. More scleral show in her photo. From looking at the article, a skin incision under the lower lash line is made. It appears (but i'm not sure because they don't elaborate) that the incision might cut through muscle and orbital septum. Again, not sure if they are also cutting through delicate eye tissue anatomy to get to bone level. They even seem to disclaim any damages via the type of cut they are making: [The infraorbital rim and lateral orbital wall are exposed maintaining the integrity of the periorbita.]

However, in BLEPHAROPLASTY, one reason people get MORE scleral show subsequent to an incision under the lower lash line IS when the muscles are cut or divided through. So, i think the scleral show (eyelid retraction or 'ectropian') could be from the type of cut they have to make to do the type of bone displacement with hip graft they need to do.

Modern blepharoplasty techniques advise against separating muscle via a skin incision ('no touch technique') to help prevent lower lid retraction. However, if they NEED to do that sort of cut to do the bone advancement and graft, I can see that in some cases, more scleral could be a trade-off as it was in the photo for that woman.