What is a Le Fort 1 osteotomy?

A Le Fort 1 osteotomy is an operation to change the position of your upper jaw so your teeth can be aligned.

What are the benefits of surgery?

Your orthodontist should be able to align your teeth so they bite together in the best way for long-term stability. The appearance of your face should also improve.

Are there any alternatives to surgery?

Your orthodontist can sometimes just use braces to straighten your teeth but it is unlikely that your teeth will bite together properly. You will usually need a permanent wire across the back of your teeth or to wear a splint at night for the rest of your life to keep your teeth in place.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about an hour.

Your surgeon will make cuts inside your mouth, above your top teeth.

They will use instruments to separate the part of your upper jaw which holds your teeth while maintaining the blood supply. Your surgeon will move your jaw and fix it in the right position using plates and screws. Your surgeon may need to trim the cartilage that separates your nostrils to prevent your nose from becoming permanently blocked.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Stopping smoking and keeping your mouth clean significantly reduces the risk of infection.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• bleeding
• bruising and swelling of your jaw, mouth and nose
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• blood clot in your leg
• blood clot in your lung
• chest infection

Specific complications of this operation

• numbness of the upper lip and gum
• the jaw not separating as planned
• not being able to open your mouth fully (trismus) and jaw stiffness
• slipping of the jaw bones in the first few weeks after the operation
• cosmetic problems
• infection of the plates and screws

Consequences of this procedure

• pain

How soon will I recover?

You should be able to go home after 1 to 3 days.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Eat only soft foods for 4 to 6 weeks, gradually moving on to solid food only when you can chew comfortably. It will take about 3 months before you can chew properly.

You should be able to return to work after 2 to 4 weeks, depending on your type of work.

The healthcare team will arrange for you to come back to the clinic regularly during the first 4 weeks.

Summary

A Le Fort 1 osteotomy is an operation to change the position of your upper jaw to help improve the way your teeth bite together. It is usually performed in addition to treatment by your orthodontist using braces.

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