General Rules in Le Fort Osteotomies: Six Steps

The Le Fort osteotomies are composed of a logical sequence of surgical steps that must be consistently followed during each procedure in order to operate successfully, with clarity and safely. Basically six surgical steps can be distinguished, from incision to osteosynthesis. Even the incision can be decisive for obtaining a sufficient overview of the surgical area, which is in general located in the central midface, in direct neighborhood to the skull base and the orbits. The spaces between the mandible and the posterior maxilla must be created technically in such a way that the overview is not impeded or even made impossible by bleeding or remaining soft tissue attachments. Especially, the identification of pterygomaxillary junction must be ensured. In higher Le Fort osteotomies, the orbital contents and, if necessary, the brain must also be protected. Great importance must be attached to the completeness of the osteotomies. Only then Le Fort osteotomies or maxillary segment osteotomies will be successful.