Upper (Maxilla) Surgery

The LeFort 1 osteotomy (Upper or maxillary surgery) is a procedure used by maxillofacial surgeons to correct a wide range of dentofacial deformities. Overall, the LeFort 1 osteotomy is a common, predictable, and safe orthognathic intervention which offers reliable long-term results.

Illustration of Upper or maxillary surgery
The LeFort I osteotomy is commonly used for the correction of malocclusion such as an underbite and overbite. Furthermore, it is commonly used to treat midface deficiencies or hypoplasia and “gummy smiles” known as vertical maxillary excess .

Patients with severe class II deformities due to mandibular retrognathism will often undergo LeFort 1 osteotomy and repositioning, in addition to mandibular advancement and osseous genioplasty, to achieve a more stable and aesthetic appearance.

In this section we will try to address some of the most common questions our patients have asked about Orthognathic surgery, in particular upper jaw (Le Fort 1) surgery.

What are the steps in the initial work up (pre-operative phase) of a patient who is planning on a Le Fort 1 procedure?

The patient usually has visited an Orthodontist and has been advised to see a surgeon to discuss surgical procedures and all available options. Frequently the combined orthodontic and surgical treatment may be a lengthy period, approximately two years. After a definite time of orthodontic treatment, the patient may then be ready for surgery. At this time the patient will undergo a detailed work up by the surgeon to determine exact surgical procedure and the precise movements needed to achieve the most ideal functional and aesthetic results. Clear communication between the patient, the surgeon and the orthodontist throughout this process are the utmost crucial steps to ensure optimal outcome.

Upper or maxillary surgery illustration closeup
Upper or maxillary surgery illustration frontal and side views

What does the pre-surgical (orthognathic surgery) workup consist of?

Once teeth are lined up, the surgeon’s work starts. At Orange County Oral Surgery and Periodontics, Dr. Bolourian offers the most advanced technology to determine jaw movements before the actual surgery.

Dr. Bolourian works in collaboration with 3D Systems, VSP® Orthognathics which offers our patients a major leap forward in virtual planning of orthognathic surgical procedures. Dr. Bolourian uses patient-specific CT (CAT SCAN) data to plan the surgery. This technology offers the ability to visualize anatomical landmarks and ensure the surgical plan matches patient’s jaw anatomy. With virtual surgical planning, we can use imaging data to accurately plan a surgical procedure on a computer prior to the actual surgery.

Is the procedure performed in office or at the Hospital?

The surgery is performed at the hospital under general anesthesia. Dr. Bolourian is on staff at Memorial Care Medical Center and routinely performs jaw surgeries that are life changing for our patients. The surgery is typically an outpatient procedure and in most cases our patients are discharged the same day.

How is the recovery for Le Fort I (Upper jaw) surgery?

This surgery is classified as a moderately invasive surgical procedure and it takes few weeks to get back to normal. Our typical patients take one to two weeks off work or school. It takes approximately six (6) weeks for the swelling to subside. Again, recovery for any surgical procedure is patient dependent. Adequate nutrition and following our post-operative instructions will ensure fast and more pleasant recovery.

Would my mouth be wired shut after the procedure?

Generally Dr. Bolourian places rubber bands to guide the teeth in good position. With rubber bands in place, patients are able to open their mouth to some extent and are able to eat soft food. In general, wiring the mouth shut is not necessary after upper jaw surgery.

When am I able to get back to work or school after upper jaw surgery?

Our typical patients are able to go back to work with limited lifting after 1 week. The recovery from a upper jaw surgery is patient dependent and would be discussed in details with you at your consultation with Dr. Bolourian.