What Is The Best Way To Fill My Maxillary Defects After a LeFort I Osteotomy?

Q: Dr. Eppley,, I underwent bimaxillary surgery which in my opinion was unsuccessful and after removing the titanium plates I found myself with holes in the central part of my face… I removed the maxillary plates because they gave me a strange appearance but now I find myself worse than before… I see my midface as completely empty, ugly and aged… i ve been thinking to have silicon midface implants but don’t know which specifically…which u suggest in my case.

A:To augment/fill in the maxillary defects you have two basic options:

1) Bone graft the maxillary defects using either allogeneic bone blocks and chips. (you could harvest your own bone but that is probably not too appealing

2) Fill in the defects with hydroxyapatite bone paste/cement

3) Make custom implants to do the contouring.

I would lean towards options 1 or 2 because it is likely there may be bone defects exposing the maxillary sinus cavity of which implants may not do well in that circumstance.

Dr. Barry Eppley

World-Renowned Plastic Surgeon