There is an interesting statement from Eppley regarding the LeFort III Osteotomy:
https://www.eppleyplasticsurgery.com/lefort-iii-osteotomy/
I can't help feeling we're going around in circles.
Since no biological facial implants are currently available, osteotomies remain the only option (in order to stay "natural"). My personal favorite is the ZSO (because it is done regularly and reliably by some surgeons).
In case someone thinks otherwise, do not hesitate to contact Dr. Wolfe or Dr. Obwegeser and convince me of the opposite.
What's 'interesting' (at least to me) about Eppley's blog entry is that the person asking a question to him, QUOTES somewhat of a STUPID statement. (I Googled where the statement appeared elsewhere. It came from 'Slut Hate' forums and associated with a '3D facial analysis' poster.) The stupid statement contends that recession of the orbital rims also 'means' the eyeballs themselves are recessed and a Lefort3 'pushes the eyeballs forward'.
So Eppley clarifies the basic concept, the most salient of it being that L3 corrects BULGING eyes by bringing the bone structure forward and NOT the eyeballs themselves. Although the person asking the question via PROXY of a STUPID quote, may not know (not knowing something is OK) the eyeballs are FIXED in place, the stupidity in the quoted statement is in the assumption that a procedure aimed at CORRECTING the look of BULGING eyes ALSO projects the eyeballs FORWARD.
Although he points out the L3 procedure isn't as 'simple and clean as shown in a diagram', there are many people (usually 'cross pollinators' from similar site the dumb quote was pulled from) who DON'T even LOOK at the L3 diagram to observe the ENTIRE area (or all the areas) it brings forward, eg. those wanting the ENTIRE L3 just to bring forward only one area it brings forward but not needing the other areas it brings forward.
https://entokey.com/wp-content/uploads/2017/02/S07_fig6_2.jpgAs to your other question: '...what about the Obwegeser girl?', I think she got the whole L3. Although she was not as syndromatic as others who get the whole L3, ALL the areas of her face that had recession were in the area the L3 addresses. IMO, she had a NICE inherent SHAPE to her bone structure at the L3 area. The only problem with it was it was backwards.
As you know, a modified L3 is not the 'whole' L3. It's quite possible that a modification of it that worked out well for one patient might not work out as well for another patient. Like any other bone cutting surgery, all it's doing is moving around someone's INHERENT structural shape. There are some people who have a nice inherent SHAPE to a part of their bone structure where the only thing (or most of the problem with it) is that it's TOO FAR backwards. So, it's going to work better on those who have the types of shapes that are going to look very good when brought forward or displaced in what ever way the procedure can displace them. That's a whole lot DIFFERENT than some who might need to have an area totally RE-SHAPED where the type of re-shaping that would enhance their aesthetic most isn't one a bone cut surgery is aimed at doing.