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Published on: May 23, 2020
Simultaneous Paranasal Augmentation and Le Fort I Osteotomy Using a Patient-Specific Implant Designed to Share the
Renato Marano1, Luis Fernando de Oliveira Gorla2, Diogo Vasconcelos Macedo3
1Private Practice, Vitória, Espírito Santo, Brazil.
The Journal of Craniofacial Surgery
|August 6, 2026
Summary
Simultaneous paranasal implants and Le Fort I osteotomy fixation offer safe midface augmentation. This single-stage approach effectively addresses residual concavity, avoiding secondary procedures with stable results over two years.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- 3D Surgical Planning
Background:
- Residual paranasal concavity can limit aesthetic outcomes after Le Fort I osteotomy.
- Simultaneous paranasal implant placement is challenging due to fixation hardware and infraorbital nerve safety concerns.
Purpose of the Study:
- To evaluate the safety and efficacy of simultaneous Le Fort I osteotomy and patient-specific paranasal implant placement.
- To assess the potential for implants to share space with fixation hardware.
Main Methods:
- Two patients underwent Le Fort I osteotomy with simultaneous placement of custom paranasal implants designed via 3D virtual surgical planning.
- Implants were fabricated from polymethyl methacrylate (PMMA) using CAD/CAM technology.
- Outcomes were assessed clinically and photographically at a minimum 24-month follow-up.
Main Results:
- Both patients achieved satisfactory midface projection without complications at 24 months.
- No implant displacement, infraorbital nerve issues, wound dehiscence, or need for plate removal occurred.
- The implants successfully coexisted with Le Fort I fixation plates.
Conclusions:
- Patient-specific paranasal implants can safely and effectively augment the midface during orthognathic surgery.
- This single-stage approach resolves residual concavity and avoids secondary procedures.
- Stable, long-term aesthetic results are achievable with this combined technique.
