What Is The Best Way To Treat My Midfacial Hypoplasia?

Q: Dr. Eppley, I would like to get an opinion on what I think should be done my concerns are mainly relating to midfacial hypoplasia – I have a skeletal Class 3. I am thinking if Jaw Surgery would be enough with Custom Implants or if I need a higher Lefort like Lefort 2 – first – I am also concerned about upper maxilla and nose. I am also concerned about the steep mandible that I have which I believe should be slightly corrected in the jaw surgery ( CCW). What do you believe overall is the best approach to my case?

A: I would agree with the concept that any jaw surgery is done first (if indicated) and any bony deficiencies above the LeFort 1 level are dealt with secondarily by custom implant designs. Never try improve bony deficiencies above the maxilla by any type of osteotomy designs. Those LeFort osteotomy designs are made for major skeletal deficiencies, usually of a syndromic origin, not more modest aesthetic deficiencies.

Dr. Barry Eppley

World-Renowned Plastic Surgeon