Restoring Balance to the Upper Jaw
A maxillary osteotomy (also known as a Le Fort I osteotomy or LF1 osteotomy) is a specialist procedure used to reposition the upper jaw (maxilla), in order to improve bite function, facial balance, and, in selected cases, airway function By addressing the underlying skeletal structure, it provides a stable, long-term correction of bite and facial balance.
Dr Tom Pepper is a Consultant Oral and Maxillofacial Surgeon in London specialising in orthognathic surgery, facial skeletal surgery, and advanced 3D surgical planning.
Who May Benefit from Maxillary Osteotomy?
A Le Fort I osteotomy may be considered for patients with:
Airway-related problems in selected cases
- Underbite (Class III malocclusion)
- Open bite
- Upper jaw deficiency (no tooth show)
- Upper jaw excess (gummy smile)
- Facial asymmetry
- Difficulty chewing
A maxillary osteotomy can reposition the upper jaw in several directions. It may be used to:
- Move the upper jaw forwards
- Move the upper jaw backwards
- Raise the upper jaw
- Lower the upper jaw
- Correct asymmetry
- Reduce a gummy smile
- Tilt the upper jaw to correct cants
- Rotate the upper jaw (counterclockwise rotation or clockwise rotation, as appropriate)
- Improve the relationship between the upper and lower jaws
Treatment is planned according to the specific anatomy and goals of the individual patient.
Maxillary Osteotomy and Facial Appearance
The position of the upper jaw has a significant influence on facial appearance.
Changes in maxillary position can affect:
- Mid-face projection
- Lip support
- Smile aesthetics
- Tooth show
- Facial profile
- Facial symmetry
For this reason, orthognathic treatment planning considers both functional correction and aesthetic facial balance.
As a Consultant Oral and Maxillofacial Surgeon with experience in facial aesthetics and facial skeletal surgery, Tom Pepper carefully evaluates how surgical movements may influence the overall appearance of the face.
Maxillary Osteotomy and Breathing
In selected patients, upper jaw position may influence airway dimensions and breathing.
Where airway concerns or sleep-disordered breathing exist, these factors form an important part of the pre-operative assessment, and may alter the treatment aims and priorities.
Orthognathic treatment may sometimes be combined with other procedures as part of a broader airway management strategy.
Advanced Surgical Planning
Every maxillary osteotomy is planned using a combination of:
- Clinical examination
- Photographic analysis
- Orthodontic records
- CT imaging
- 3D virtual surgical planning
Digital planning allows surgical movements to be visualised before surgery and helps ensure accurate transfer of the treatment plan to the operating theatre.
This improves precision, predictability and communication throughout treatment.
What the Procedure Involves
Surgery is performed under general anaesthetic in a hospital setting.
- The upper jaw is carefully mobilised
- It is repositioned in a controlled, planned position
- It is stabilised with small medical fixation plates
All incisions are made inside the mouth, so there are no visible external scars.
The procedure is planned in detail in advance, often in coordination with orthodontic treatment.
Recovery
Recovery is gradual and supported throughout.
In the early phase, you can expect:
- Swelling and bruising, reducing over several weeks
- A modified diet while healing progresses
- Regular review to monitor recovery and stability
Most patients return to normal activities within a few weeks, with continued refinement as swelling settles.
Results
The outcome addresses both function and appearance.
Patients typically notice:
- Improved alignment of the teeth and bite
- Better balance between the upper and lower face
- A more comfortable, natural jaw function
Results are stable and long-lasting, reflecting a correction at the skeletal level.
Frequently Asked Questions
What is a Le Fort I osteotomy?
A Le Fort I osteotomy is a surgical procedure used to reposition the upper jaw in order to improve bite function, facial balance and jaw relationships.
Will upper jaw surgery change my appearance?
Yes. Repositioning the upper jaw can influence smile aesthetics, lip support, facial profile and overall facial proportions. Changes are carefully planned to achieve natural and balanced results.
Will I need braces?
Most orthognathic patients require orthodontic treatment before and after surgery.
Are there visible scars?
No. Incisions are normally placed entirely inside the mouth.
Is a counterclockwise rotation (CCW rotation) or a clockwise rotation better?
Neither! Which is best for you depends on your starting point, treatment goals, and the results of a comprehensive facial, dental, and aesthetic assessment.
How long is recovery?
Initial recovery occurs over two weeks, with a modified diet continuing over six weeks.
Why Choose Dr Tom Pepper?
Treatment is carried out by a Consultant Maxillofacial Surgeon with specialist expertise in facial anatomy, occlusion, and surgical planning.
Careful assessment ensures that:
- Treatment is appropriate
- Outcomes are both functional and proportionate
- The result integrates naturally with your features
Is This the Right Treatment for You?
A detailed consultation allows for full assessment, including clinical examination and imaging where required.
This ensures a clear understanding of:
- your specific concerns
- whether surgery is appropriate
- the expected outcome and recovery
Arrange a Consultation
For assessment and discussion of maxillary osteotomy in London, arrange a consultation to explore your options in detail.