Variations of Le Fort II osteotomies for correction of midfacial deformities.

For the correction of the retruded midface and simultaneous correction of the occlusion, 3 different types of osteotomies are presented. All 3 procedures are related to the originally described Le Fort II fracture lines. Whereas the anterior and pyramidal Le Fort II type osteotomies are only indicated in very special and rare deformities, the quadrangular type can be applied more widely. Technical details as well as possible complications are discussed. Damage to the lacrimal apparatus and the infraorbital nerve can be avoided when these structures infraorbital nerve can be avoided when these structures are handled are fully. Relapse, however, is still the main concern, particularly in the quadrangular type osteotomy. Overcorrection is therefore recommended.