What is Lefort 1 surgery?

Le Fort I surgery is one of the orthognathic surgical procedures performed to correct the position of the upper jaw. Le Fort I surgery is planned especially when the upper jaw is positioned too far back, too far forward, too low, too high, or asymmetrically in relation to the facial midline. The aim of this surgery is not only to change aesthetic appearance; it is also to bring dental occlusion, chewing function, facial proportions, and in some patients breathing comfort into better balance. In patients evaluated by Dr. Tansu Üzel, the process is planned individually by analyzing facial structure, dental bite, jaw relationship, and the patient’s expectations together.

What Is Le Fort I Surgery?

Le Fort I surgery is a procedure in which the upper jawbone is moved with controlled surgical cuts and placed into a new, more accurate position. In medical terminology, it is also known as “Le Fort I osteotomy.” In this procedure, the part of the upper jaw that carries the teeth can be repositioned forward, backward, upward, downward, or at certain angles in harmony with the facial skeleton. Le Fort I osteotomy is one of the main orthognathic surgical methods that allows the upper jaw to be repositioned three-dimensionally.

This surgery is commonly considered in cases such as jaw bite disorders, upper jaw retrusion, facial asymmetry, improper contact between the teeth, excessive gum visibility while smiling, or insufficient midface support. Le Fort I surgery should not be considered an operation that concerns only the area under the nose or the teeth. Since the upper jaw is one of the main structures supporting the middle part of the face, changes in this area also affect the overall facial proportions.

For What Purpose Is Le Fort I Surgery Performed?

Le Fort I surgery is performed to correct skeletal problems originating from the upper jaw. In some people, the upper jaw may be positioned behind the lower jaw. In this case, the facial profile may appear flatter, the lower jaw may seem more prominent than it actually is, and dental occlusion may not be healthy. In some people, the upper jaw is positioned too low, causing the gums to appear noticeably when smiling. This condition is commonly known as a “gummy smile.”

The main goal of the surgery is to bring the upper jaw into harmony with the rest of the face. Dental occlusion, lip support, the area under the nose, midface appearance, and jaw relationship are evaluated together. Therefore, Le Fort I surgery is a procedure with both functional and aesthetic results. By placing the upper jaw in the correct position, chewing may become more balanced, dental occlusion may improve, and the facial profile may appear more proportionate. Le Fort I surgery can help improve dental bite by changing the position of the upper jaw and is often planned together with orthodontic treatment.

Who Is Suitable for Le Fort I Surgery?

Le Fort I surgery may be suitable for people who have skeletal-level positional disorders in the upper jaw structure. However, not every jaw bite problem requires surgery. In some cases, orthodontic treatment may be sufficient, while in cases with a significant skeletal discrepancy, surgical planning may be required. This distinction is made through detailed examination, X-rays, tomography, intraoral assessment, and digital analyses.

Suitable candidates are generally expected to have completed their growth and development. This is because permanent surgical planning performed while the jawbones are still developing may be affected by changes in the facial structure over time. In addition, the person’s general health condition, oral hygiene, dental status, and compliance with treatment are also important. In the treatment approach prepared for Dr. Tansu Üzel, not only the patient’s appearance but also chewing, speaking, bite, and breathing problems experienced in daily life are taken into consideration.

In Which Situations Is Le Fort I Surgery Considered?

Le Fort I surgery may be considered for different problems originating from the upper jaw. The common point of these problems is that the upper jaw is not in a harmonious relationship with the face and lower jaw.

• Upper jaw retrusion: When the upper jaw is positioned behind the lower jaw, the midface may appear flat in profile.
• Excessive upper jaw development: Excessive downward development of the upper jaw may increase gum visibility while smiling.
• Jaw bite disorder: Failure of the teeth to make healthy contact may affect chewing function and dental health.
• Facial asymmetry: The upper jaw being shifted to the right or left may create imbalance in the facial midline.
• Open bite: Failure of the front teeth to touch each other may cause problems during speaking, biting, and chewing.
• Insufficient midface support: Upper jaw retrusion may cause an appearance of inadequate support around the area under the nose and the cheeks.

Each of these conditions requires different surgical planning. Therefore, Le Fort I surgery is not a standard procedure but a personalized orthognathic surgical method shaped according to the individual’s facial and jaw structure.

How Is Planning Performed Before Le Fort I Surgery?

Planning before Le Fort I surgery is one of the most important stages determining the success of the operation. In this process, not only how much the upper jaw will be moved is calculated, but also how this movement will reflect on facial aesthetics and dental occlusion. The patient’s facial photographs, dental models, radiological images, and bite analysis are evaluated together.

Orthodontic preparation is an important part of this process. Proper positioning of the teeth on the jawbones makes it easier to achieve a healthy bite after surgery. Some patients may need orthodontic treatment for a certain period before surgery. In some cases, surgery-first approaches may also be considered. This decision is made according to the patient’s jaw structure and treatment goals.

During planning, the face is evaluated from the front, side, and three-dimensional perspectives. Since the movement of the upper jaw may create changes in the nasal base, upper lip, smile line, and facial profile, these areas must be assessed in detail. When planned correctly, Le Fort I surgery can provide a more balanced appearance while preserving the natural facial expression.

How Is Le Fort I Surgery Performed?

Le Fort I surgery is a surgical procedure performed under general anesthesia. The operation is carried out through incisions made inside the mouth, so no externally visible incision scar is formed. During surgery, the upper jawbone is separated along the planned lines and placed into its previously determined new position. It is then fixed with bone plates and screws. This fixation helps the upper jaw maintain its correct position during the healing process.

Whether the operation is performed as single-jaw surgery or together with double-jaw surgery varies depending on the patient’s needs. In some people, upper jaw intervention alone may be sufficient, while in some patients a more comprehensive plan involving the lower jaw or chin tip may be required. During Le Fort I surgery, the goal is not merely to move the upper jaw, but to place it at the most balanced point in terms of dental occlusion and facial proportions.

The surgical technique may vary according to the patient’s anatomy. How much the upper jaw will be advanced, impacted, lowered, or moved toward the midline is determined through preoperative analyses. Therefore, the success of the surgery depends not only on surgical skill but also on accurate planning.

What Is the Recovery Process Like After Le Fort I Surgery?

The early period after Le Fort I surgery is the stage when swelling and sensitivity are most noticeable. Facial swelling, a feeling of fullness around the nose, numbness in the upper lip, or limited mouth opening may occur. These may be among the expected parts of the postoperative healing process. Swelling is more noticeable in the first days and then gradually decreases.

Nutrition requires attention during this period. In the first weeks, a soft and liquid-based diet is generally recommended. Avoiding hard foods is important so that the jawbones can adapt to their new position and the tissues inside the mouth can heal. Oral hygiene should also not be neglected during this process. Since the incisions are inside the mouth, cleanliness contributes to healthy healing.

Full recovery varies from person to person. Bone healing, soft tissue recovery, reduction of swelling, and settling of facial contours take time. It is not accurate to evaluate the final appearance of the face in the first weeks. After Le Fort I surgery, facial proportions gradually achieve a more natural and balanced appearance.

What Should Be Considered After Le Fort I Surgery?

The points to be considered after Le Fort I surgery affect both healing comfort and preservation of the surgical result. It is very important for the patient to follow the doctor’s recommendations during this period.

• Nutrition should be carefully managed: In the early period, hard, crusty foods and foods requiring intense chewing should be avoided.
• Oral hygiene should not be neglected: Because of the incisions inside the mouth, cleaning should be performed regularly and gently.
• Follow-up appointments should not be skipped: Follow-up appointments planned by Dr. Tansu Üzel are important for monitoring healing.
• Facial trauma should be avoided: Trauma should be avoided to protect the newly positioned jawbone.
• Smoking should be avoided: Smoking may negatively affect tissue healing.
• Heavy exercise should not be performed without doctor approval: In the early period, activities that increase blood pressure may increase swelling and sensitivity.

These recommendations are for general informational purposes. Since every patient’s surgical plan and recovery process are different, personal instructions must always be followed according to the guidance of the surgeon performing the operation.

How Does Le Fort I Surgery Affect Facial Appearance?

Since Le Fort I surgery changes the position of the upper jaw, it can provide a noticeable balance in the middle part of the face. In people with upper jaw retrusion, the midface may appear more supported, the upper lip may be positioned more evenly, and the profile appearance may become more harmonious. In cases where the upper jaw is positioned too low, the amount of gum visible while smiling may decrease, and facial length may be perceived as more balanced.

The important point here is that the surgery does not transform the person into someone completely different, but corrects the disproportion in the facial structure. After correctly planned Le Fort I surgery, the face appears more balanced while the person’s natural expression is preserved. Patients often notice positive changes not only in their jaw bite but also in facial proportions in photographs and in smile aesthetics.

The degree of change in facial appearance depends on the direction and amount of movement of the upper jaw. Therefore, expectations should be discussed realistically before surgery. While evaluating the patient’s facial structure, Dr. Tansu Üzel approaches the process with a planning concept that considers not only bone movement but also how this movement will reflect on the soft tissues.

Is Le Fort I Surgery Risky?

As with every surgical procedure, Le Fort I surgery carries certain risks. These may include bleeding, infection, swelling, temporary or permanent numbness, sinus-related complaints, failure to achieve the desired bite result, or the need for a second intervention. However, proper patient selection, detailed planning, surgical experience, and regular follow-up help reduce these risks.

The patient’s general health condition is also important in risk assessment. Factors such as bleeding disorders, uncontrolled systemic diseases, inadequate oral hygiene, or smoking may affect the healing process. Therefore, the medical history must be shared completely before surgery.

Le Fort I surgery is an orthognathic surgical method that can be performed safely when carried out by an experienced team in the field. However, this procedure should not be seen as a simple aesthetic intervention; it should be understood as a serious jaw surgery.

Frequently Asked Questions About Le Fort I Surgery

Is Le Fort I Surgery Painful?

Since Le Fort I surgery is performed under general anesthesia, the patient does not feel pain during the operation. After surgery, pressure, swelling, and a feeling of tightness may be more prominent than pain. These complaints can be controlled with medications and care instructions recommended by the doctor. Although the first days may be more sensitive, comfort increases as healing progresses. Since pain threshold varies from person to person, the process is not experienced in the same way by every patient.

Are Braces Required After Le Fort I Surgery?

Le Fort I surgery is planned together with orthodontic treatment in most patients. The reason for this is that while the jawbones are placed in the correct position with surgery, the teeth must also be brought into harmony with this new bite. Some patients use braces before surgery, while in some patients orthodontic adjustment continues after surgery. How the treatment will proceed is determined according to the position of the teeth, the level of bite disorder, and the surgical plan.

Will There Be a Scar on the Face After Le Fort I Surgery?

Since Le Fort I surgery is performed through incisions made inside the mouth, no visible surgical scar forms on the outer part of the face. The incisions are located inside the lip and close to the gum line. Therefore, an incision that is noticeable from the outside is not expected aesthetically. Swelling and bruising may occur in the early postoperative period; however, these do not mean permanent scarring. As the healing process is completed, the facial appearance becomes more natural.

Is Le Fort I Surgery a Permanent Procedure?

Le Fort I surgery is a permanent procedure performed by fixing the bones in their new position. However, accurate planning, healthy bone healing, a good orthodontic bite, and regular follow-up are important for maintaining the result in the long term. In some complex cases, small changes may occur over time. For this reason, postoperative follow-up appointments are as important a part of the treatment as the surgery itself.