Le Fort Osteotomies or maxillary osteotomy surgeries are a group of procedures performed to correct the position of the upper jaw, nose and cheekbones. The most commonly performed procedure is the Le Fort I Osteotomy, which changes the position of the upper jaw to ensure correct alignment of the teeth, where teeth are rooted in the upper jaw and cannot be aligned without moving it. It can also remedy a cleft palate.
What is involved in a Le Fort I Osteotomy?
A Le Fort I osteotomy takes around 2-3 hours and is performed under general anaesthetic. Where a bone graft is required to complete the procedure, the bone tissue is often removed from the hip bone.
First, the surgeon makes a few incisions above the upper teeth and then separates the upper jaw. The upper jaw is then moved into the correct position and fixed in place with screws and plates, and in some cases nasal cartilage is trimmed to keep the nasal passages clear. Finally soluble stitches are used to close the incisions.
What are the risks of a Le Fort I Osteotomy?
A le Fort I Osteotomy carries several risks including nerve, skin, artery and tear duct damage, blood loss (which may require a blood transfusion), infection, buckling or breaking of the septum (nasal bone), bones necrosis (death of the bone tissue) and unanticipated bone fractures (which may in very rare cases may cause leaking of the spinal fluid). Also there is a possibility of the bones, screws or plates moving after surgery and causing further problems. There is also a risk that the cosmetic result will be unsatisfactory or asymmetrical; as your face can continue to change up to 1 year after a Le Fort Osteotomy, only time may tell if the final result will be satisfactory of whether further surgery may be required.
How long will it take me to recover from a Le Fort I Osteotomy?
After your Le Fort I Osteotomy, you may be in some pain and there may be moderate swelling which should begin to subside within the next 2 days. Your jaw will be stiff and possibly numb, and you may not be able to move it normally for a few weeks. Dry lips and a blocked nose are very common, and your nose may bleed frequently. However, it is vital that you don’t attempt to blow your nose until your surgeon is happy that you are beginning to heal.
You may not be able to eat anything for the 1-2 days, and for a few weeks your food will have to be pureed.
You will need to remain in hospital for 1-3 days and have someone to care for you at home for around a week. Depending on how your healing progresses, you can expect to spend 2-4 weeks at home before returning to work.
What is the cost of a Le Fort I Osteotomy?
In the UK, a Le Fort I Osteotomy is usually performed under the NHS. Private prices vary and you will need an individual quote prepared after attending an initial consultation and scans, as osteotomies are complex procedures. However, you should expect a Le Fort Osteotomy to cost at least several thousand pounds.