Lefort 1 Surgery

[auferstehen92]

---

Members don't see this ad.

I apologize in advance if this is the wrong place to post this type of question. I know this isn't a dental advice forum, but I was just hoping for some reassurance from people knowledgeable in OMFS. I'm a first year medical student and will be having a Lefort I osteotomy at the beginning of my 5 week summer break.

Mostly I'm just wondering if a Lefort I is a sort of "bread and butter" procedure for someone trained in OMFS. I'm having the procedure in a mid-sized city, but I didn't really get to chose my surgeon due to insurance issues. and timing concerns. After watching the procedure on Youtube and reading about some of the potential complications, I guess I'm more than a little on edge about the whole thing. Should I be? Is tissue necrosis like an actual concern or is that something that only happens in Mexican back alley clinics? Is a Lefort 1 pretty much a Lefort 1 regardless of the surgeon, or is there a subjective component to the surgery that significantly affects aesthetics?

Thank you!

 

[Mordecai]

A Lefort I osteotomy is a pretty standard operation for a surgeon from a decent training program. What I would find out is whether your surgeon does the operation frequently. Tissue necrosis is not common occurrence, happening in about 1% of cases. However it depends on the nature of the movement of the maxilla. The risk is higher in people with clefts, or previous palatal surgery, large movements or segmental movements (2 or 3 piece surgery). There are other complications that are more frequent, like bleeding. In terms of the aesthetic outcomes, it really does depend on the planning of the operation, as well as a certain artistic eye of the surgeon on the "facial balance" that will result from the movement. In summary, experienced surgeon from good training program with regular experience in the procedure= better outcome.

 

[2TH MVR]

I would assume you are also working with an orthodontist? I've seen some orthognathic treatments with less than desirable outcomes due to a lack of planning with the orthodontist. The little white objects in your mouth have to fit properly in order for the result to be stable.

As mentioned above .... make sure the OMFS has done many LeFort procedures. Find out if it will be a 1,2, or 3 piece LeFort. Again .... a lot depends on your malocclusion.

 

[sgv]

It's pretty routine.

OMFS 1: "What kind of case are you doing today?"
OMFS 2: "Just a Lefort"

Where I'm at, it takes the attending and chief less than an hour to perform.

Multipiece Lefort are a little more technical.