New Photos of Modified LeFort III

[Bowie]

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.

Wow very interesting information and certainly makes sense, thanks.

I think most people on here who were interested in LF3, wanted it to reduce scleral show / bulging eye appearance. So not a good idea to go to this surgeon who increases scleral show / rounded eye appearance through his technique.

[kavan]

Wow very interesting information and certainly makes sense, thanks.

I think most people on here who were interested in LF3, wanted it to reduce scleral show / bulging eye appearance. So not a good idea to go to this surgeon who increases scleral show / rounded eye appearance through his technique.

Well '6 of one and 1/2 dozen of the other' as one person has more of it and the other person doesn't. Just sayin' that the under eye cut to do it looks to be what they try to avoid doing in modern bleph techniques. But again, if they have to use it to advance the bone and put a hip graft in there, well, that's what they have to do. Might not be a bad idea to have a revision blepharoplasty doc lined up just in case.

[PloskoPlus]

All mlf3 access methods have tradeoffs - this one, coronal, canthal... Wolford claims to do modified lf3 completely intraorally. But I think that puts a restriction on how far up and to the side he can go.

[secondtimearound]

Why not just stick with more traditional bone surgeries and do something like an infraorbital implant for example like dr. Eppley offers?

I am a non candidate for this as I am a revision patient and need sarpe, but this seems like it would likely be much riskier for not that much benefit.

It also wouldn't allow asymmetry correction.

So it would be of limited benefit to a very limited patient population.

[Lazlo]

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

exactly right. this procedure sucks and these patients are borderline syndrome. Most of the improvement is from the lefort 1.

[secondtimearound]

exactly right. this procedure sucks and these patients are borderline syndrome. Most of the improvement is from the lefort 1.

It's to be expected because bringing forward the cheekbones with zygomatic surgery even by 3-5 mm is never dramatic either.

If you want stronger under eye area or zygos you would need a way to grow massive amounts of new bone in those areas.. Which is not possible.

Agreed these people are mostly nuts.