Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft

CPT4 code

Name of the Procedure:

Reconstruction midface, LeFort I; single piece, segment movement in any direction (e.g., for Long Face Syndrome), without bone graft

Summary

This surgical procedure involves repositioning the upper jaw (maxilla) to correct facial and dental issues. It is done without the use of a bone graft and is typically used to treat conditions such as Long Face Syndrome.

Purpose

The procedure aims to correct facial aesthetics and improve dental function. It helps address issues of an elongated face, misalignment of the jaw, and bite problems.

Indications

Long Face Syndrome
Severe malocclusion (misaligned bite)
Facial asymmetry
Speech difficulties related to jaw position
Difficulty chewing or biting

Preparation

Fasting for 8-12 hours before surgery if general anesthesia is used.
Adjustments to medications as advised by your surgeon.
Preoperative imaging studies (e.g., X-rays, CT scans) to plan the surgery.

Procedure Description

Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
Incision: The surgeon makes an incision inside the mouth to access the bones of the upper jaw.
Repositioning: The maxilla is carefully separated and moved to the desired position. Movement can be in any direction necessary to achieve the correct alignment.
Fixation: Plates and screws are used to secure the bone in its new position.
Closure: The incisions are closed with sutures that will either dissolve or be removed later.

Duration

The procedure typically takes between 2 to 4 hours.

Setting

This surgery is usually performed in a hospital or a surgical center.

Personnel

Orthognathic Surgeon
Anesthesiologist
Nursing staff
Surgical assistants

Risks and Complications

Infection
Bleeding
Nerve injury, resulting in numbness
Difficulty in healing or improper bone fusion
Postoperative pain and swelling
Sinus issues

Benefits

Improved facial aesthetics and symmetry
Enhanced dental function and bite alignment
Better chewing and speaking abilities
Increased self-confidence with improved appearance

Recovery

Hospital stay for 1-2 days for observation.
Swelling and bruising around the face, which typically subsides within a few weeks.
Soft or liquid diet for several weeks.
Follow-up appointments for monitoring and suture removal.
Avoid strenuous activities for 4-6 weeks.
Full recovery expected in 6-12 weeks.

Alternatives

Orthodontic treatment alone, though it may not be sufficient for severe cases.
Use of bone grafting techniques for more complex or extensive reconstruction.
Non-surgical cosmetic treatments, though they may not address functional issues.
Each alternative has its own risks, benefits, and limitations.

Patient Experience

Under general anesthesia, you will be asleep and feel no pain during the surgery.
Postoperative discomfort managed with pain medication.
Temporary changes in facial sensation that typically improve over time.
Follow-up care includes regular monitoring and adherence to dietary restrictions to facilitate healing.