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Nasal considerations with the Le Fort I osteotomy

From Volume 12, Issue 3, July 2019 | Pages 92-97


Timothy McSwiney

BDS(Hons), MFDS RCS, DClinDent(Orth), MOrth RCS, FDS(Orth) RCS

Locum Consultant Orthodontist, Dublin Dental University Hospital, 2 Lincoln Place, Dublin, Ireland

Articles by Timothy McSwiney

Email Timothy McSwiney

Daljit Dhariwal


Consultant Oral and Maxillofacial Surgeon, John Radcliffe Hospital, Oxford, UK.

Articles by Daljit Dhariwal


Orthognathic surgery involves the correction of severe dentofacial deformities through a combination of orthodontics, surgery and, occasionally, restorative dentistry. This procedure, when involving surgical movement of the maxilla, can lead to changes in the overlying nasal morphology. In this paper, the standard nasal assessment that is undertaken prior to a Le Fort I osteotomy is outlined along with the reported nasal changes seen following this procedure. In addition, the various risk factors associated with adverse nasal changes are considered, as are the management techniques adopted by clinicians to minimize these changes

CPD/Clinical Relevance: Clinicians should be aware of the adverse nasal changes associated with the Le Fort I osteotomy.


A Le Fort I osteotomy is performed to correct an underlying midface skeletal deformity and to improve facial aesthetics.1 It can be used to correct discrepancies in both the antero-posterior and vertical dimensions and is widely adopted by maxillofacial surgeons owing to its relative simplicity and efficiency. Although complications associated with this procedure are uncommon, careful evaluation of the nose should take place prior to this procedure. Typically, undesirable changes in the nasal region, such as widening of the alar base or upturning of the nose, can accompany this procedure.1,2,3 Careful pre-surgical planning, as well as intra-operative preventive techniques, have the potential to limit these undesirable changes. This article aims to cover the clinical evaluation of the nose prior to a Le Fort I osteotomy, the reported nasal changes seen following this procedure, the risk factors associated with these adverse nasal changes and the techniques employed to minimize possible adverse outcomes.

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