Le Fort I Surgery: Cost, Recovery & Results in US

Le Fort I osteotomy, a precise surgical technique, is frequently performed by skilled oral and maxillofacial surgeons across the United States to correct maxillary hypoplasia and other midface deformities. The costs associated with Le Fort I surgery can vary significantly, influenced by factors such as the complexity of the case and the geographic location, with urban centers generally reflecting higher prices compared to rural areas. Post-operative recovery following Le Fort I surgery typically involves a period of swelling and dietary restrictions, managed through detailed protocols to ensure optimal bone healing and functional outcomes. The aesthetic and functional results of Le Fort I surgery often lead to improved facial harmony and enhanced quality of life for patients seeking correction of skeletal imbalances.

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull base. It allows for precise repositioning to correct skeletal imbalances. These imbalances can significantly impact a person's bite, breathing, and facial appearance.

Definition and Purpose of Le Fort I Osteotomy

Le Fort I Osteotomy is primarily aimed at correcting vertical, anteroposterior, or transverse discrepancies of the maxilla. These discrepancies can manifest in various ways, impacting both function and aesthetics.

• Correcting Vertical Maxillary Discrepancies: This includes conditions like maxillary hypoplasia (underdevelopment of the upper jaw) or maxillary excess (overgrowth). These conditions can lead to significant facial imbalances. Surgical intervention can restore a more harmonious facial profile.

• Addressing Malocclusion: Le Fort I Osteotomy plays a crucial role in correcting malocclusion issues, such as open bite (a gap between the upper and lower teeth when the mouth is closed) and crossbite (where the upper teeth sit inside the lower teeth). By repositioning the maxilla, the procedure facilitates proper dental alignment and improves overall dental function. This includes chewing, speaking, and maintaining oral hygiene.

• Improving Facial Aesthetics: Beyond functional correction, Le Fort I Osteotomy significantly enhances facial aesthetics. It achieves this by harmonizing the upper jaw position with other facial features. The goal is to achieve a balanced and proportionate appearance. This can boost confidence and improve overall quality of life.

The Multidisciplinary Team: A Collaborative Approach

The success of Le Fort I Osteotomy hinges on a collaborative effort from a multidisciplinary team of specialists. Each member brings unique expertise to the table. They contribute to comprehensive patient care.

• Oral and Maxillofacial Surgeons (OMFS): OMFS surgeons are the cornerstones of this procedure. They possess the specialized training and expertise to perform the Le Fort I Osteotomy. They lead the surgical planning and execution, ensuring precision and optimal outcomes.

• Plastic Surgeons: Collaboration with plastic surgeons is crucial for aesthetic refinement and soft tissue management. They address any soft tissue concerns that may arise during or after the procedure. This is to optimize the overall aesthetic result.

• Orthodontists: Orthodontists play a pivotal role in both pre- and post-operative care. Before surgery, they align the teeth to prepare for the repositioning of the maxilla. Post-operatively, they fine-tune the bite and ensure long-term stability.

• Anesthesiologists: Patient comfort and safety are paramount. Anesthesiologists are essential in ensuring a smooth surgical experience. They manage anesthesia, monitor vital signs, and provide pain relief during and after the procedure.

• Nurses: Nurses are essential in direct patient care. They provide pre-operative education, post-operative monitoring, and administer medications. They are critical to ensure a comfortable and safe recovery for the patient.

Understanding the Anatomy: Key Structures in Le Fort I Surgery

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull base. It allows for precise repositioning to correct skeletal imbalances. Understanding the complex anatomy involved is paramount. It’s important to both surgical planning and minimizing potential complications.

The Maxilla: The Keystone of the Procedure

The maxilla, or upper jaw, is the primary focal point of the Le Fort I Osteotomy. This bone is not merely a static structure. It’s a complex framework that supports the midface. It dictates the position of the teeth. It contributes significantly to facial aesthetics.

The Le Fort I osteotomy carefully cuts through the maxillary walls above the teeth roots and below the nasal floor. This allows the entire tooth-bearing segment of the upper jaw to be moved as a single unit.

Precise repositioning is essential. It addresses vertical, horizontal, and transverse discrepancies. It must restore proper occlusion and facial harmony.

Navigating the Nasal Cavity

The nasal cavity's proximity to the surgical field demands meticulous attention. Altering the maxilla's position can inadvertently affect nasal function and airway patency.

Surgical techniques must prioritize minimizing nasal airway compromise. This can include careful soft tissue management and avoiding excessive superior repositioning of the maxilla. Pre-existing nasal airway obstruction necessitates thorough evaluation and management. This is before proceeding with Le Fort I osteotomy.

Maxillary Sinuses: Avoiding Complications

The maxillary sinuses are air-filled spaces within the maxilla. They present a potential source of complications during Le Fort I Osteotomy. Sinus membrane perforation is a risk during the osteotomy cuts. This can lead to sinusitis or oroantral fistula formation.

Careful surgical technique is key. This will minimize the risk of sinus complications. The surgeon must be aware of the variable size and position of the sinuses. If perforation occurs, meticulous repair of the sinus membrane is essential.

Teeth and Occlusion: The End Goal

The relationship between the teeth and the planned osteotomy is a critical consideration. The surgeon must preserve tooth vitality during the procedure. The surgeon must also consider the proximity of tooth roots to the osteotomy site. Pre-operative orthodontic treatment is often necessary to align the teeth. This prepares them for the final occlusion after surgery.

The ultimate goal is achieving a stable and functional occlusion. This requires collaboration between the surgeon and orthodontist.

The Mandible: Balancing the Facial Skeleton

While the Le Fort I Osteotomy focuses on the maxilla, the mandible (lower jaw) cannot be ignored. Often, maxillary repositioning necessitates a combined approach with mandibular surgery. This is typically a Sagittal Split Ramus Osteotomy (SSRO).

These combined procedures ensure a harmonious and balanced facial skeleton. They improve both aesthetics and function.

The Temporomandibular Joint (TMJ)

Alterations to the maxilla's position can impact the temporomandibular joint (TMJ). Pre-existing TMJ dysfunction must be carefully assessed and managed. This is done both before and after surgery.

Surgical planning should aim to minimize stress on the TMJ. In some cases, TMJ surgery may be necessary. This is in conjunction with the Le Fort I osteotomy.

Alveolar Bone: Foundation for Dental Stability

The alveolar bone is the portion of the maxilla that surrounds and supports the teeth. Maintaining its integrity during Le Fort I osteotomy is paramount. It’s essential for long-term dental stability.

Excessive bone removal or aggressive surgical techniques can compromise alveolar bone support. This increases the risk of tooth loss. Preservation of alveolar bone is a key objective.

The Hard Palate: Anatomical Landmark

The hard palate forms the roof of the mouth. It’s an important anatomical landmark during Le Fort I Osteotomy. The osteotomy cuts extend along the lateral nasal walls. They connect at the anterior nasal spine. It also extends along the inferior edge of the hard palate.

Careful consideration of the palate's anatomy ensures accurate execution of the osteotomy. The surgeon must also avoid injury to the palatal soft tissues and neurovascular structures.

Surgical Planning and Techniques: Precision in Action

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull, repositioning it, and securing it in its new location. The success of this procedure hinges on meticulous surgical planning and the employment of advanced surgical techniques, ensuring both accuracy and optimal patient outcomes.

Pre-operative Assessment: Laying the Foundation for Success

The journey to a successful Le Fort I Osteotomy begins with a comprehensive pre-operative assessment. This crucial phase involves a thorough evaluation of the patient's facial structure, skeletal relationships, and dental occlusion.

This assessment often encompasses a combination of clinical examinations, cephalometric radiographs, and cutting-edge 3D imaging techniques.

Clinical examination provides invaluable information about facial symmetry, soft tissue contours, and the patient's overall health.

Cephalometric radiographs offer a detailed skeletal analysis, allowing the surgeon to identify specific maxillary discrepancies and plan the osteotomy accordingly.

3D imaging, such as cone-beam computed tomography (CBCT), provides a three-dimensional view of the facial skeleton, enabling precise visualization of anatomical structures and potential surgical challenges.

The Power of Digital Planning: CASP and VSP

In modern orthognathic surgery, Computer-Aided Surgical Planning (CASP) and Virtual Surgical Planning (VSP) have become indispensable tools. These technologies revolutionize the way Le Fort I Osteotomies are planned and executed.

CASP and VSP utilize sophisticated software to create a virtual model of the patient's skull, allowing the surgeon to simulate the osteotomy and predict post-operative outcomes with remarkable accuracy.

This digital planning process allows for:

• Precise osteotomy design, minimizing the risk of complications.
• Accurate prediction of post-operative facial aesthetics.
• Creation of customized surgical guides and splints to aid in the execution of the procedure.

By leveraging CASP and VSP, surgeons can optimize surgical outcomes, reduce operative time, and enhance patient satisfaction.

Surgical Techniques: A Step-by-Step Approach

The Le Fort I Osteotomy procedure itself involves a series of carefully executed steps.

It typically begins with:

1. Incisions made inside the mouth to access the maxilla.
2. Precise osteotomy cuts are then performed to separate the upper jaw from the skull.
3. The maxilla is carefully downfractured, allowing for mobilization and repositioning.

The repositioning phase is critical, as the maxilla is moved into its planned position to correct the underlying skeletal discrepancy and improve occlusion.

Fixation: Securing the New Position

Once the maxilla is in its desired position, it is secured using bone plates and screws.

These fixation devices provide stability and promote bone healing, ensuring the long-term success of the procedure.

The choice of fixation method depends on various factors, including the extent of the osteotomy, the patient's bone quality, and the surgeon's preference.

Minimally Invasive Techniques: Piezoelectric Surgery

Piezoelectric surgery has emerged as a valuable adjunct to traditional Le Fort I Osteotomy techniques. This innovative technology utilizes ultrasonic vibrations to cut bone with remarkable precision and minimal trauma to surrounding soft tissues.

The benefits of piezoelectric surgery include:

• Reduced bleeding.
• Decreased post-operative swelling.
• Faster healing times.

By minimizing soft tissue damage, piezoelectric surgery can contribute to a more comfortable and predictable recovery for patients undergoing Le Fort I Osteotomy.

Surgical Guides and Splints: Enhancing Accuracy

3D printing technology has revolutionized many aspects of modern medicine, and orthognathic surgery is no exception.

3D-printed surgical guides and splints are increasingly used to enhance the accuracy and predictability of Le Fort I Osteotomies.

Surgical guides are custom-designed templates that fit over the teeth or bone, guiding the surgeon during the osteotomy cuts to ensure precise placement.

Splints are used to stabilize the maxilla in its new position during the fixation phase, further enhancing the accuracy of the procedure.

Enhanced Visualization: Surgical Microscopes

Surgical microscopes are valuable tools that provide enhanced visualization during Le Fort I Osteotomy.

These microscopes offer magnified views of the surgical field, allowing the surgeon to identify and protect delicate anatomical structures, such as nerves and blood vessels.

By improving visualization, surgical microscopes can contribute to a safer and more precise surgical outcome.

Indications for Le Fort I Osteotomy: When is it Necessary?

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull, repositioning it to achieve a more harmonious facial structure and optimal dental occlusion. Understanding the specific conditions that warrant this procedure is crucial for both patients and practitioners.

Correcting Skeletal Discrepancies

Le Fort I Osteotomy is frequently employed to correct significant skeletal discrepancies that affect both facial appearance and bite alignment. These discrepancies often manifest as imbalances in jaw size or position, leading to functional and aesthetic issues.

Maxillary hypoplasia, or a deficient upper jaw, can result in a retruded midface and a Class III malocclusion (underbite). This condition not only impacts facial aesthetics but can also compromise breathing and speech.

Maxillary excess, conversely, leads to an elongated face and potential gummy smile. Le Fort I Osteotomy can effectively shorten the maxilla, creating a more balanced facial profile.

Addressing Malocclusion

Malocclusion, or a misalignment of the teeth, is another primary indication for Le Fort I Osteotomy. When malocclusion stems from underlying skeletal issues, surgery is often the most effective solution.

Open Bite Correction

Anterior open bite, characterized by a gap between the upper and lower front teeth when the jaws are closed, is a common problem addressed with this procedure.

By repositioning the maxilla, the bite can be closed, improving chewing efficiency and speech articulation.

Crossbite Correction

Crossbite, where the upper teeth bite inside the lower teeth, can also be corrected using Le Fort I Osteotomy. This condition often results from maxillary underdevelopment or asymmetry.

Surgical intervention can widen or reposition the maxilla, establishing a normal bite relationship and preventing future dental problems.

Enhancing Facial Aesthetics

Beyond functional improvements, Le Fort I Osteotomy plays a significant role in enhancing facial aesthetics. The procedure can address concerns such as gummy smiles and facial asymmetry, leading to improved self-confidence and quality of life.

Gummy Smile Reduction

A gummy smile, characterized by excessive gingival display when smiling, can be effectively treated with Le Fort I Osteotomy.

By superiorly repositioning the maxilla, the amount of visible gum tissue is reduced, creating a more pleasing smile.

Facial Asymmetry Correction

Facial asymmetry, where one side of the face differs significantly from the other, can be improved with Le Fort I Osteotomy.

Careful planning and execution of the surgery can reposition the maxilla to create a more balanced and symmetrical facial appearance.

Reconstructive and Trauma Applications

Le Fort I Osteotomy extends beyond elective procedures and has crucial applications in reconstructive surgery and trauma management.

Cleft Lip and Palate Reconstruction

In cases of cleft lip and palate, Le Fort I Osteotomy plays a vital role in restoring maxillary continuity and function. This complex surgery helps to close palatal defects and improve facial symmetry.

Facial Fracture Reconstruction

Le Fort I Osteotomy can also be employed in the reconstruction of complex maxillary fractures resulting from trauma. It allows for precise realignment of the fractured segments, restoring facial structure and function.

A Multifaceted Solution

In summary, Le Fort I Osteotomy is indicated in a wide range of conditions, from skeletal discrepancies and malocclusion to aesthetic concerns and reconstructive needs. Its versatility and effectiveness make it a cornerstone of orthognathic surgery.

Financial and Legal Aspects: Understanding the Costs and Consent

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull, repositioning it to achieve optimal alignment and balance. However, beyond the surgical expertise, a crucial dimension often underestimated is the financial and legal framework surrounding the procedure.

Navigating the costs, insurance coverage, and the critical process of informed consent is paramount for patients considering Le Fort I Osteotomy.

Cost Considerations: A Detailed Breakdown

Understanding the financial implications of Le Fort I Osteotomy is essential for patients. The overall cost is a multifaceted equation, encompassing various components.

Surgeon's Fees

This constitutes the remuneration for the Oral and Maxillofacial Surgeon (OMFS) or team of surgeons performing the procedure. These fees can vary significantly based on the surgeon's experience, reputation, and geographic location.

Anesthesia Fees

Administering anesthesia requires a qualified anesthesiologist. Their fees are typically determined by the duration and complexity of the surgery.

Facility Charges

The surgical facility (hospital or surgical center) will levy its own charges, covering the use of the operating room, recovery area, and nursing staff. These facility fees can often be a substantial portion of the total cost.

Pre-operative Imaging and Planning

Prior to surgery, detailed imaging is required to assess the skeletal structure and plan the osteotomy.

These costs might include:

• Cephalometric radiographs
• 3D CT scans
• Virtual Surgical Planning (VSP) services

Post-Operative Care

Medications for pain management, post-operative appointments, and physical therapy can add to the cost.

Understanding Insurance Coverage

Insurance coverage for Le Fort I Osteotomy is a critical aspect that patients must investigate thoroughly.

Coverage can vary substantially based on the insurance plan, the medical necessity of the procedure, and the specific diagnosis.

Pre-Authorization Processes

Most insurance companies require pre-authorization before proceeding with Le Fort I Osteotomy. This involves submitting detailed documentation, including clinical notes, imaging reports, and treatment plans, to justify the medical necessity of the surgery.

Appealing Denials

Insurance companies can deny coverage if they deem the procedure cosmetic or not medically necessary. Patients have the right to appeal these denials.

The appeal process often involves providing additional documentation, expert opinions, and letters of medical necessity from the treating surgeon and orthodontist.

Persistence and thorough documentation are crucial in appealing denials.

Out-of-Pocket Expenses

Even with insurance coverage, patients are likely to incur out-of-pocket expenses, such as deductibles, co-payments, and co-insurance. It's essential to understand these costs upfront to budget accordingly.

Legal and Ethical Considerations: Informed Consent

Informed consent is a cornerstone of ethical medical practice. It ensures that patients have a clear understanding of the proposed procedure, its potential benefits, risks, and alternatives, allowing them to make autonomous decisions about their health.

Discussing Risks, Benefits, and Alternatives

The informed consent process for Le Fort I Osteotomy should include a detailed discussion of the following:

• Benefits: Expected improvements in facial aesthetics, occlusion, and function.
• Risks: Potential complications, such as infection, bleeding, nerve damage, malunion, nonunion, relapse, and sinus problems.
• Alternatives: Non-surgical options, such as orthodontics alone, or alternative surgical procedures.

Addressing Potential Complications

Patients must be made aware of the potential complications associated with Le Fort I Osteotomy.

The surgeon should openly discuss the likelihood of each complication, the measures taken to minimize these risks, and the potential management strategies should they occur.

Documentation

The informed consent discussion should be documented in writing, with the patient signing a consent form to acknowledge their understanding and agreement to proceed with the surgery.

Post-operative Care and Recovery: What to Expect After Surgery

Le Fort I Osteotomy is a transformative surgical procedure designed to address a spectrum of maxillary (upper jaw) deformities. It’s a powerful tool used to correct both functional and aesthetic concerns.

This intricate surgery involves carefully separating the upper jaw from the skull and repositioning it to achieve the desired outcome.

The surgery itself, however, is only one part of the equation. A successful outcome hinges significantly on diligent post-operative care and a structured recovery process. Understanding what to expect and how to navigate this phase is paramount for patients.

Immediate Post-operative Phase: The First Few Days

The immediate aftermath of a Le Fort I Osteotomy requires meticulous attention. Swelling, bruising, and pain are inevitable, and proactive management is crucial.

Managing Swelling and Bruising

Post-operative swelling is typically at its peak within the first 48 to 72 hours. Consistent application of ice packs to the face, coupled with keeping the head elevated, is essential to minimize inflammation.

Elevation aids in fluid drainage, reducing both swelling and discomfort. Medications, as prescribed by your surgeon, will also play a vital role in managing inflammation.

Pain Management Strategies

Pain management is a priority during the initial recovery phase. Prescription analgesics are the primary tool for controlling pain, but adjunctive therapies can also provide relief.

These may include:

• Relaxation techniques.
• Comfortable positioning.
• Distraction methods.

It is important to adhere strictly to the prescribed medication schedule and communicate any concerns about pain levels to your surgical team.

Navigating Dietary Restrictions

Following a Le Fort I Osteotomy, dietary restrictions are necessary to protect the healing maxilla. A liquid or soft food diet is typically recommended for several weeks.

This minimizes stress on the surgical site and allows for proper bone healing. Examples of appropriate foods include:

• Broths.
• Smoothies.
• Pureed soups.
• Yogurt.

Consult with your surgeon or a registered dietitian to ensure adequate nutrition during this period.

Maintaining Optimal Oral Hygiene

Maintaining strict oral hygiene is critical to prevent infection and promote healing. Gentle rinsing with an antiseptic mouthwash, as prescribed by your surgeon, is crucial.

Avoid brushing directly on the surgical site until cleared by your surgeon. Proper oral hygiene is essential to prevent complications.

Long-Term Recovery: Restoring Function and Stability

The long-term recovery phase focuses on restoring jaw function, stability, and achieving the final desired outcome.

The Role of Physical Therapy

Physical therapy plays a crucial role in regaining optimal jaw function. Targeted exercises can help restore range of motion, muscle strength, and coordination.

A physical therapist experienced in treating post-orthognathic surgery patients can develop a personalized rehabilitation plan to address specific needs and limitations.

Follow-up Appointments and Monitoring

Regular follow-up appointments with both the surgical and orthodontic teams are essential to monitor healing, occlusion, and stability.

These appointments allow for early detection of any potential complications and ensure that the treatment plan remains on track.

The frequency of follow-up visits will gradually decrease as healing progresses, but ongoing monitoring is crucial for long-term success.

Potential Risks and Complications: What Could Go Wrong?

Le Fort I Osteotomy, while a transformative procedure, is not without potential risks and complications. Understanding these possibilities is crucial for informed consent and realistic expectations. While modern surgical techniques and meticulous planning significantly minimize the likelihood of adverse events, it’s essential to acknowledge and discuss potential challenges openly. This section will delve into common and less frequent complications, providing a balanced perspective on the surgical journey.

Common Surgical Risks

Like any surgical procedure, Le Fort I Osteotomy carries inherent risks such as infection, bleeding, and nerve damage. Careful surgical technique and adherence to post-operative protocols are essential to mitigate these risks.

Infection

Infection is a potential complication following any surgical procedure. In Le Fort I Osteotomy, the surgical site is in close proximity to the oral cavity, which harbors a diverse range of bacteria.

Prophylactic antibiotics are typically administered before and after surgery to reduce the risk of infection. However, if an infection does develop, it may require further antibiotic treatment, drainage, or even surgical debridement.

Bleeding

Significant bleeding during or after surgery is a risk, although advancements in surgical techniques and hemostatic agents have made this less common. In rare cases, a blood transfusion may be necessary to replace lost blood volume. Meticulous surgical technique and careful intraoperative management are crucial to minimize blood loss.

Nerve Damage and Altered Sensation

The Le Fort I Osteotomy involves manipulating bone and tissues in close proximity to nerves that provide sensation to the upper lip, cheeks, and palate. Damage to these nerves can result in altered sensation, such as numbness, tingling, or pain.

In most cases, nerve damage is temporary, and sensation gradually returns over several months. However, in rare instances, nerve damage can be permanent. Microsurgical techniques and careful dissection can help minimize the risk of nerve injury.

Bone Healing Complications

Complications related to bone healing, such as malunion (incorrect bone alignment) or nonunion (failure of the bone to heal), can occur, although they are relatively uncommon.

Malunion and Nonunion

Malunion occurs when the bone fragments heal in an incorrect position, potentially leading to facial asymmetry or malocclusion. Nonunion occurs when the bone fragments fail to heal together, resulting in instability and pain. Both malunion and nonunion may require revision surgery to correct the problem.

Factors that can increase the risk of malunion or nonunion include infection, inadequate blood supply, and poor patient compliance with post-operative instructions. Ensuring proper stabilization of the bone fragments with plates and screws, meticulous surgical technique, and patient adherence to post-operative care guidelines can help minimize the risk of these complications.

Long-Term Stability and Sinus Issues

Long-term stability and potential sinus problems also need consideration when evaluating the risks associated with Le Fort I Osteotomy.

Relapse

Relapse, or the gradual movement of the jaw back towards its original position, is a potential long-term complication. Several factors can contribute to relapse, including inadequate initial correction, muscle pull, and skeletal instability.

Orthodontic retention and, in some cases, further surgical intervention may be necessary to address relapse. Careful surgical planning, proper fixation techniques, and long-term follow-up are crucial to minimize the risk of relapse.

Sinus Problems

The maxillary sinuses are located in close proximity to the upper jaw, and the Le Fort I Osteotomy can potentially affect sinus function. Sinusitis (inflammation of the sinuses) and oroantral fistula (an abnormal connection between the oral cavity and the maxillary sinus) are potential complications.

Prevention of sinus issues include careful surgical technique to minimize trauma to the sinus lining and appropriate management of any existing sinus conditions.

So, that's the lowdown on Le Fort I surgery in the US. It's a big decision with a journey to match, but hopefully, this has given you a clearer picture of the costs, the recovery process, and what you can expect in terms of results. Remember to chat with your surgeon – they're the best resource for determining if Le Fort I surgery is the right path for you.