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General Category => Functional Surgery Questions => Topic started by: PloskoPlus on September 30, 2014, 06:45:48 AM

Title: Le Fort I height and facial "angularity"
Post by: PloskoPlus on September 30, 2014, 06:45:48 AM
Surgery next week.  Originally my surgeon said he'd cut a bit higher "to fill out the face".  4 months ago, seeing my much leaner face, he said normal Le Fort I to maintain the angularity.  A couple of weeks ago he again said just a bit higher than a normal Le Fort I.  According to him "normal" is just above the teeth roots.  "Slightly higher" - 1 to 2 mm above normal.  What the hell does it mean?  (Addressed especially to those who've seen my mug in the private forum).

Title: Re: Le Fort I height and facial "angularity"
Post by: Gregor Samsa on September 30, 2014, 07:05:08 AM
I still don't understand why you think a zygomatic osteotomy won't work for you? Is it because your face will end up too wide?
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on September 30, 2014, 07:08:46 AM
I still don't understand why you think a zygomatic osteotomy won't work for you? Is it because your face will end up too wide?

Yes.  The crappy phone camera selfies in the private forum make my face narrower than it really is.
Title: Re: Le Fort I height and facial "angularity"
Post by: Modigliani on September 30, 2014, 07:41:54 AM
Can ZO not be performed purely to increase anterior projection?
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on September 30, 2014, 02:03:26 PM
Can ZO not be performed purely to increase anterior projection?
I don't quite understand the mechanics of ZO.  My surgeon talks in terms of "hinging out", so a lateral component seems unavoidable.
Title: Re: Le Fort I height and facial "angularity"
Post by: Optimistic on September 30, 2014, 03:03:55 PM
I don't quite understand the mechanics of ZO.  My surgeon talks in terms of "hinging out", so a lateral component seems unavoidable.

I think in this case simply using bio-oss / HA paste would be one way of getting lateral projection without the added width.
Title: Re: Le Fort I height and facial "angularity"
Post by: Modigliani on September 30, 2014, 03:08:33 PM
Or even just a tradition silicone implant.
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on September 30, 2014, 03:20:01 PM
My surgeon told me that width and flatness just below the eyes often come in a package.
Title: Re: Le Fort I height and facial "angularity"
Post by: Modigliani on September 30, 2014, 03:37:47 PM
Ugh, always a bloody trade off with all these fixes  ::)
Title: Re: Le Fort I height and facial "angularity"
Post by: LoveofScotch on September 30, 2014, 03:44:47 PM
I just have a hard time imagining how cutting 1-2mm "slightly higher" up would produce a negative aesthetic result.

What are your thoughts, PP?
Title: Re: Le Fort I height and facial "angularity"
Post by: ticktickatick on September 30, 2014, 05:24:43 PM
(http://lrubio.es/Facial/Imagenes/LeFortsAP.gif)

From this picture it looks like standard lefort 1 at the teeth roots is right before you hit the nose. Do you have extra space there for them to cut without...cutting into your nasal area?
Title: Re: Le Fort I height and facial "angularity"
Post by: Alue on October 01, 2014, 01:16:09 AM
Does doing a higher lefort I make "the pig nose effect" (aka nose looking upturned after forward movement) after surgery worse or does it make pig nose effect less noticeable? If I ever have le fort I to move my jaw forward, I worry about the nose because to me, my nose is great the way it is in terms of size, projection and nostril width/shape. I am afraid of doing anything such as shaving down the anterior nasal spine or alar cinch.

I worry about the same thing.  I think widening of the nose is common, as far as upturn, maybe slightly but depends on the amount of advancement. 
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 01, 2014, 03:35:18 AM
I just have a hard time imagining how cutting 1-2mm "slightly higher" up would produce a negative aesthetic result.

What are your thoughts, PP?

Surgeon: higher Le Fort fills out the face, normal Le Fort - face more angular.  Dunno.
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 01, 2014, 03:36:49 AM
(http://lrubio.es/Facial/Imagenes/LeFortsAP.gif)

From this picture it looks like standard lefort 1 at the teeth roots is right before you hit the nose. Do you have extra space there for them to cut without...cutting into your nasal area?

Well my upper lip is exactly average length or 1 mm shorter than average, I forget.  But my face is big - width and length.
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 01, 2014, 03:38:51 AM
I wonder if i were to have 5 mm advancement if i could get away with not doing anything to my nose? I think in any case, i would probably just leave my nose alone and see how it looks after surgery( that is if i'm having surgery, ==>>whole other story).

So IF the result turned out to be too upturned/piggy, then i would just go for a nose job later because i am against the idea of nasal bone shaving and alar cinch during jaw surgery. I have a small nose (I am asian) and I do not like the idea of removing any bone from my nose.

I don't think it's a good idea to micromanage the surgeon.  Theoretically he should know better.  Find a good surgeon and trust his aesthetic sense to do the right thing.

(I wish I could operate on myself, but I can't).
Title: Re: Le Fort I height and facial "angularity"
Post by: Nataliepryor on October 01, 2014, 04:34:06 AM
Not the same I know, I was cut high for my SAPRE, very high...base of my nose (felt like I had a nose job).

My result, compared to others is the same...swelling in top half of face and any discomfort was in my nose and more intense.  When I spoked to the office about it, they said it can be a decision made at time of surgery and I was cut high, so the nose will be super tender, but result the same. Gave me a little appreciation of rhinoplasty !!  :o
Title: Re: Le Fort I height and facial "angularity"
Post by: Nataliepryor on October 01, 2014, 04:36:15 AM
The nasel spray they give you, will become your best friend!

Please post after op, when you can... love to hear how you going!
Title: Re: Le Fort I height and facial "angularity"
Post by: LoveofScotch on October 01, 2014, 12:24:09 PM
Surgeon: higher Le Fort fills out the face, normal Le Fort - face more angular.  Dunno.

Take this for what it's worth...

Yes, your face is wide, but it's not shaped like a box. Everything tapers downward (in a good way, and it's especially evident after your weight loss). And I was under the impression cutting a little higher up allowed for more of a forward component with the lateral component being negligible at best. If that's the case, wouldn't cutting a little higher up be better for you? Are you concerned a higher cut will exaggerate your flat(ish) under eye area? (Sorry.)
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 06, 2014, 01:59:51 AM
Take this for what it's worth...

Yes, your face is wide, but it's not shaped like a box. Everything tapers downward (in a good way, and it's especially evident after your weight loss). And I was under the impression cutting a little higher up allowed for more of a forward component with the lateral component being negligible at best. If that's the case, wouldn't cutting a little higher up be better for you? Are you concerned a higher cut will exaggerate your flat(ish) under eye area? (Sorry.)

Dunno, tired of thinking about this.  The surgeon told me to stop obsessing over this.  He's reputed to produce "natural results", FWIW.  I give up. Surgery is on Thursday, got the hooks put on my braces today.  I was told that it's best to put them on the day before because people find them annoying, but they don't bother me.  (As a matter of fact braces hardly bothered me, except for the cleaning aspect.)... I digress.
Title: Re: Le Fort I height and facial "angularity"
Post by: Modigliani on October 06, 2014, 05:58:16 AM
Good luck for Thursday, Plusko, at this stage of the game you have to just trust that your surgeon will have your best interests at heart. Easier said than done though, right?

Have you got everything you need for recovery? I found busying myself with organising that stuff a good way to take my mind off the actual event.
Title: Re: Le Fort I height and facial "angularity"
Post by: LoveofScotch on October 06, 2014, 09:39:43 AM
Good luck this week, PP :)

I hope everything goes great!
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 06, 2014, 11:25:29 AM
Have you got everything you need for recovery? I found busying myself with organising that stuff a good way to take my mind off the actual event.

Umm, no, I've organised nothing.  What do I need?

Just woke up from a nightmare - my bite is completely off post surgery, my teeth are falling out.
Title: Re: Le Fort I height and facial "angularity"
Post by: Alue on October 06, 2014, 01:03:59 PM
good luck!
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 06, 2014, 01:35:04 PM
Thank you, all!

I've lowered my expectations. I hope that helps.
Title: Re: Le Fort I height and facial "angularity"
Post by: notrain on October 06, 2014, 01:41:44 PM
good luck plosko.
Title: Re: Le Fort I height and facial "angularity"
Post by: petebite on October 06, 2014, 06:49:31 PM
Good luck, mate! I'm sure you will be fine.
Title: Re: Le Fort I height and facial "angularity"
Post by: Nataliepryor on October 09, 2014, 02:27:35 AM
Hope all went great!! 

....and your teeth didn't fall out like in your dream  :-X
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 09, 2014, 06:37:47 PM
Hope all went great!! 

....and your teeth didn't fall out like in your dream  :-X

All done.  Surprisingly, I feel completely fine.
Title: Re: Le Fort I height and facial "angularity"
Post by: petebite on October 09, 2014, 07:26:04 PM
All done.  Surprisingly, I feel completely fine.

Great news. How's does the result seem so far, any positive responses from your surgeon? It's early days (day?) yet though so probably not much to tell.
Title: Re: Le Fort I height and facial "angularity"
Post by: Nataliepryor on October 09, 2014, 07:43:34 PM
Omg that's awesome!! So glad your feeling good!

I was driving on Thursday and thought of you having it done that morning  :)

When your feeling good, love to hear all the juicy details!!
Title: Re: Le Fort I height and facial "angularity"
Post by: PloskoPlus on October 09, 2014, 10:15:08 PM
Pete, Natalie,

I plan to post the gory details in the private forum.  If you are not members, I will PM you.
Title: Re: Le Fort I height and facial "angularity"
Post by: Nataliepryor on October 10, 2014, 02:26:27 AM
Ok great . PM me, have not used private forum.  Cannot wait to have a good read !!

Hope your sleeping ok.
Title: Re: Le Fort I height and facial "angularity"
Post by: Modigliani on October 10, 2014, 02:51:46 AM
Well done, big guy!