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Le Fort Osteotomy
WHAT YOU NEED TO 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.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- An IV is a small tube placed in your vein that is used to give you medicine or liquids.
- Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
- Intubation: After you are asleep, you will have a nasotracheal tube (thin plastic tube) put into your nose. If you are having surgery around your nose, you will have an endotracheal tube put in through your mouth. These tubes connect to a breathing machine to help you breathe during surgery.
- Antibiotic medicine: You may be given antibiotic medicine right before surgery to help prevent an infection caused by bacteria. You may also need to take this medicine after surgery.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
During your surgery:
- An incision is 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 are fractured and moved. Your bones are 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, helps hold your bones in place and helps with healing.
- Sometimes, your caregiver will attach a device called a distractor to your head during surgery. The distractor is used to move your face bones farther apart. All of your cuts are stitched closed. 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. You may need to wear the distractor on the outside of your head for a few days. Another surgery will remove the distractor and set your bones in place.
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. You may have devices attached to your head. Your upper and lower jaw may be joined together using elastic bands or wires. It may be hard to open your mouth when you wake up.
- Wound care: Ask your caregiver to show you how to care for your wounds.
- Diet: You may be able to eat only soft foods or liquids for a time after surgery. Caregivers will tell you when you can eat your usual diet.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- 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.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
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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.