Modified Le Fort I osteotomy with preservation of the anterior nasal spine position: preliminary report

We present a modification of the traditional Le Fort I osteotomy by means of which the anterior nasal spine is left intact. The osteotomies advance from the posterior-lateral side of the maxillary bone through the tuberosity to the inferior-lateral wall of the piriform opening. Two other vertical osteotomies from the lateral side of the piriform opening are placed in a 90 degree fashion to connect with another horizontal osteotomy that runs 5 mm below the floor of the nasal cavity and the anterior nasal spine. In a series of 50 patients with Le Fort I osteotomies, we have performed this new technique in 5 patients. We have observed better esthetic results in terms of nasal tip position and a more predictable value for the nasolabial angle. We believe that this technique is more appropriate for larger advancements in which a large gap may occur at the end of the movement.