Le Fort Osteotomy
What you should know
Le Fort osteotomy is surgery to fracture and move bones in your face. There are 3 types of Le Fort surgery. Each type of surgery moves different bones in your face. During Le Fort I surgery, your maxillary bone (area just above your upper teeth) is fractured. During Le Fort II surgery, fractures are made above your nose and in your upper jaw. During Le Fort III surgery, fractures are made through your cheekbones and the bones around your eyes.
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- You may lose a lot of blood during the surgery and need a blood transfusion. You may have pain, an infection, bleeding, or skin damage from the surgery. Metal plates and screws placed during surgery could become loose, move, or cause an infection. If an infection occurs, you may need another surgery to correct the problem. You may feel the hardware through your skin. Your bones may not heal well, and may move back to the way they were before surgery.
- You may not look the way you expected after Le Fort surgery. Changes in your face can continue for up to 1 year after surgery. The movement of your face bones may change the shape of your nose or lips. Your bones may break in a different place than expected. Your teeth could be damaged, or you could have problems using your teeth. Rarely, bones in your head may break, causing spinal fluid to leak out of your ears or nose.
Before your surgery:
- Write down the correct date, time, and location of your surgery.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Caregivers will work with you to plan the changes they will make to your face. The position of your cheekbones, jaw and teeth, and the look of your nose and lips may change.
- You may need tests to measure your face such as x-rays, CT scans, and other scans. These tests help caregivers plan your surgery. These tests also may be done after surgery to see the changes that were made to your face. Ask your caregiver about these or other tests you may need. Write down the date, time, and location of each test.
The night before your surgery:
Ask caregivers about directions for eating and drinking.
The day of your surgery:
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- You may be given antibiotic medicine through your IV to help prevent an infection caused by bacteria.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
What will happen:
- You will be taken on a stretcher to the operating room and moved onto a special bed. You will receive general anesthesia to keep you asleep during surgery. After you are asleep, a tube connected to a breathing machine will be placed through your nose or mouth. This machine will breathe for you during your surgery.
- An incision will be made in your mouth above your top row of teeth. Other cuts may be made in the area of your eyelids or hairline, depending on the type of Le Fort surgery you need. Your face bones will be fractured and moved. Your face bones will be held in place using metal plates and screws. Your caregiver may place tiny pieces of bone in your face from other places in your body. This process, called bone grafting, will help hold your bones in place and help with healing. Other surgeries may be done at the same time as your Le Fort surgery to change the look of your face. These surgeries may change the shape of your nose, lower jaw, or chin.
After your surgery:
You will be taken to your room once you are fully awake. Do not get out of bed until your caregiver says it is okay. Depending on your surgery, you may have devices attached to your head. Your upper and lower jaw may be joined together using elastic bands or wires. You may be unable to open your mouth after surgery. You may need to eat a liquid or soft diet.
Contact a caregiver if
- You cannot make it to your surgery.
- You have a fever.
Seek Care Immediately if
- You have new or increasing problems breathing.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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