Author Topic: Which surgeons perform segmental le fort 1 setback of maxilla?  (Read 3466 times)

sean89

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Which surgeons perform segmental le fort 1 setback of maxilla?
« on: September 03, 2014, 09:26:28 PM »
in Europe please?

I know that SARPE has taken over in most places now, but I only need minor expansion and minor setback, 2mm in both directions, rather than going through SARPE and BSSO (with wisdom teeth extraction).

Modigliani

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #1 on: September 04, 2014, 06:51:04 AM »
Hi Sean,

Not sure any surgeons would agree to do it for such small movements - the whole risk/reward thing.

sean89

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #2 on: September 04, 2014, 07:27:45 AM »
Hmm, maybe you're right but the surgery would be ideal for me since it addresses every orthognathic problem that I have left. I would also benefit from the 1mm impaction that comes from the le fort cut.

I have already been told that I could have SARPE and BSSO performed for such minor movements, but multiple surgeries and treatment phases would be unnecessary if segmental setback was done, plus most maxillary movements are relatively minor anyway, in comparison to bsso and genios.

Gregor Samsa

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #3 on: September 04, 2014, 08:12:59 AM »
Didn't you have a chin wing with Zarrinbal? Did you ask him?

sean89

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #4 on: September 04, 2014, 08:38:36 AM »
No, I may reconsult with him though, but from what I gathered from Kizarq, he prefers SARPE. Whether that means he doesn't do segmental le fort, I don't know, but he was prepared to do SARPE on me, but the small amount of widening I would need could be done with segmental le fort rather than SARPE.


Gregor Samsa

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #5 on: September 04, 2014, 08:54:49 AM »
What's the precision on these kinds of small movements? It sounds hard to get it just right.

sean89

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #6 on: September 04, 2014, 09:15:07 AM »
What's the precision on these kinds of small movements? It sounds hard to get it just right.

I have no idea.

I think it can be done pretty accurately (1.5mm either way) and I think, but may be wrong, that there is less chance of alar flaring with setback and with smaller movements. From what I've seen, the worst flaring comes from large advancements.


Gregor Samsa

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #7 on: September 04, 2014, 10:11:23 AM »
sean, sorry if i go OT. but are you happy with your chin wing? could you give me some details? thanks

He created a topic about it a while ago: http://jawsurgeryforums.com/index.php/topic,3872.msg26062.html

Mark32

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #8 on: September 04, 2014, 03:19:38 PM »
hi Sean,

Quote
...plus most maxillary movements are relatively minor anyway, in comparison to bsso and genios.

are movements of the maxilla usually quite small because it's most often less misaligned than the lower jaw? sort of like saying that when things go wrong they do so mostly in the mandible? that would be reassuring for me as I think my maxilla might have to come forward and i'm worrying that too much movement there would give me a sort of protrusion in that area. especially as I have a short, turned up nose. :-[

oh, is sarpe where they expand your upper jaw widthwise or something?

hi Modigliani

Quote
Not sure any surgeons would agree to do it for such small movements - the whole risk/reward thing.

roughly speaking, is there a sort of lower limit to the amount of movement a surgeon will consider?

sean89

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #9 on: September 04, 2014, 05:27:07 PM »
hi Sean,

are movements of the maxilla usually quite small because it's most often less misaligned than the lower jaw? sort of like saying that when things go wrong they do so mostly in the mandible? that would be reassuring for me as I think my maxilla might have to come forward and i'm worrying that too much movement there would give me a sort of protrusion in that area. especially as I have a short, turned up nose. :-[

oh, is sarpe where they expand your upper jaw widthwise or something?

hi Modigliani

roughly speaking, is there a sort of lower limit to the amount of movement a surgeon will consider?


I think large maxillary movements are unstable. The nose changes are unpredictable but I think large advancements are more likely to bring about the worst flaring.

Yes, SARPE is for arch width.


thanks greg, i knew this however, i just hoped he could give us some update! im having the same surgery, and malar osteotomy, in a month!!!

I'm happy with the results. My chin and lip sensation is normal, but my lower gums are still very numb. I saw a picture of Tyson Ballou before and started wondering whether I should have got jaw implants instead, but the risks are too high and I'm glad I made the decision I did.

My regret is that I didn't get bimax alongside it, and so my chin has been compensated to hide my retrognathia so any further lower jaw movements would be too much. Upper jaw, as you can see from this thread, is still a very real option but it is still up in the air and dependent on cost. I will do more research and in the meantime, get braces because there is no way around them, and I only really realised the importance of fixing my teeth when I saw a video of me speaking in motion. Always go off videos and not pictures when analysing your flaws imo.

Tiny

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #10 on: September 04, 2014, 06:46:56 PM »
Always go off videos and not pictures when analysing your flaws imo.

Dunno, I think it depends on the flaw.  Personally I look 10x better in moving videos than static pics.  With pictures, any asymmetry and even minor skin issues is a lot more obvious....depends on the person, some people (eg models) look better in pictures than real life, for some people it's the other way round

RE: segmental lefort, no idea sorry!!

sean89

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Re: Which surgeons perform segmental le fort 1 setback of maxilla?
« Reply #11 on: September 04, 2014, 06:53:48 PM »
https://www.youtube.com/watch?v=HPjRGUSywBU

I think this is what I need but with expander.