LeFort Osteotomy

About LeFort Osteotomy

LeFort osteotomy is the standard surgical solution for mid-face deformities involving the upper jaw and adjoining bones. The maxilla is carefully separated from surrounding facial structures along a planned cut line, then repositioned to its ideal location. Movements may include forward advancement for retruded jaws, upward impaction for vertical excess, downward grafting for short faces, and rotational changes to correct asymmetry. The result is improved bite, breathing and facial proportion, all addressed in a single coordinated operation.

Maxillary osteotomy is most often combined with orthodontic care. Pre-surgical orthodontics, typically seven to twelve months long, aligns the teeth correctly within the upper arch so the jaws can fit together precisely after surgery. A second post-surgical phase finishes the bite. In severe cases, LeFort osteotomy is paired with BSSO of the lower jaw to form bi-jaw surgery, and frequently with genioplasty to refine the chin. The whole plan is unified rather than treated as separate procedures.

Indications for LeFort osteotomy include maxillary hypoplasia (an under-developed mid-face), open bite, gummy smile from vertical maxillary excess, mid-face deficiency in cleft patients, asymmetry and certain syndromic conditions. Skeletal growth must be complete before surgery, usually by 15 to 16 years in girls and 17 to 18 years in boys. Some carefully selected paediatric cases involving maxillary excess or syndromes are exceptions, and Dr. Agarwal, FRCS Edinburgh, decides such timing on individual merit.

The operation is performed under general anaesthesia. An incision inside the upper lip allows access to the maxilla, which is divided along a controlled plane and repositioned to its planned new location guided by 3D virtual planning. Titanium plates and screws hold the new position securely. There are no external scars. A hospital stay of two to three nights is typical, with structured pain control, careful nasal hygiene and a soft diet plan handed over before discharge.

What to expect

• 3D virtual planning to rehearse cuts and movements before theatre
• Pre-surgical orthodontics, typically seven to twelve months
• General anaesthesia with experienced anaesthetic cover
• Incision inside the upper lip; no visible facial scars
• Maxilla repositioning fixed with titanium plates and screws
• Hospital stay of two to three nights with structured pain control
• Coordinated post-surgical orthodontics to settle the final bite

Recovery

• Significant swelling and bruising for the first two to three weeks
• Soft and liquid diet for roughly six weeks while bones consolidate
• Nasal congestion is common in the first week and gradually clears
• Most patients return to office work in three to four weeks
• Strict oral hygiene with prescribed rinses and gentle brushing
• Final aesthetic and bite result matures over six to twelve months