Le Fort I Osteotomy + Bilateral Sagittal Split Osteotomy (SSRO)
A Le Fort I osteotomy (hereafter “Le Fort”) horizontally cuts the maxilla, allowing it to be moved forward/backward, up/down, and side-to-side, then fixed at the ideal position. It corrects skeletal disharmony such as mouth protrusion or excessive mid-face height. Le Fort alone is rarely sufficient; because it can upset the bite or affect the nose and other areas, it is usually combined with a bilateral sagittal split osteotomy (“SSRO”) of the mandible.
Although Le Fort + SSRO was originally designed to improve occlusion, balancing the skeleton also transforms overall facial appearance, so it is now widely used for cosmetic goals.
Because jaw position changes after surgery, orthodontic treatment is sometimes required. To guarantee care quality, we work closely with experienced orthodontists and can refer you to a reliable dental clinic.
By performing Le Fort osteotomy combined with SSRO and rotating both the upper and lower jaws, it is possible to recreate the contour of the face—visible from a diagonal angle—even from the front, resulting in a smaller, more refined facial appearance. Because simply changing the impression of the mouth area can create an elegant and polished look, this procedure is highly sought after.
Le Fort
Le Fort is a technique that horizontal cut is made near the nasal base of the maxilla; the bone is shifted into place and fixed with plates and screws.
SSRO
SSRO is a technique that each mandibular ramus is split sagittally so the lower jaw can be moved forward, backward, or rotated.
Segmental Osteotomy (Upper and Lower Jaws)
This surgery improves mouths that jut forward or appear small-chinned because of dental protrusion (“rogobo” or “buck teeth”). In mild cases of dental protrusion, orthodontic treatment alone may be sufficient; however, when the maxillary bone itself is positioned too far forward, surgery to reposition the jawbone is required.
Segmental osteotomy involves extracting the first premolars (upper left, upper right, lower left, and lower right) and using the space created to move the anterior teeth and surrounding alveolar bone backward.
Because this results in the retraction of both the upper and lower jaws, the procedure is also commonly referred to as “setback surgery.”
After the operation, orthodontic treatment is necessary to close the spaces between the canines (tooth #3) and second premolars (tooth #5).
At our clinic, we collaborate with experienced orthodontists who specialize in post-surgical care to ensure each patient receives the most appropriate treatment.
Ideal for anyone who feels they have…
- A protruding mouth
- A large chin
- A small chin
- A long chin
- A retruded/“witch” chin
- Buck teeth
- A gummy smile
- A facial asymmetry
- A long face
- A squared face
- A big face
- Prominent cheekbones
- Flared jaw angles
- A Protruding mouth
- Buck teeth
Procedure Details
Le Fort I Osteotomy + Bilateral Sagittal Split Osteotomy (SSRO)
Significant transformation can be achieved by repositioning both the upper and lower jaws. By combining Le Fort and SSRO osteotomies, the jaws can be rotated posteriorly, allowing the facial contour seen from a diagonal angle to be recreated—resulting in a more refined and smaller-looking face.
This procedure enhances the facial contour by refining the V-line seen from a diagonal angle, ensuring it appears beautifully balanced even from the front—further amplifying the small-face effect.
Because the technique suppresses mouth protrusion and creates a sophisticated profile, it is chosen by many patients. For example, rotating the lower jaw clockwise tightens the jawline when viewed frontally, yielding a sharper, smaller look. In practice we blend horizontal and rotational movements to craft the optimum plan for each patient.
Recovery, Downtime & Precautions
Swelling & Bruising
Swelling and bruising are most noticeable during the first 2 to 3 days after surgery, but they gradually subside over 1 to 2 weeks and typically resolve completely within about six months.
Daily Life
To stabilise the bite, the upper and lower jaws are rubber-banded for about 3 weeks. You can speak but cannot open wide, so nutrition must come from liquid or soft foods. We provide IV drips to limit swelling and pain and offer comprehensive after-care to shorten downtime.
We provide IV drips to limit swelling and pain and offer comprehensive after-care to shorten downtime.
Possible Risks and Side-Effects
Potential complications of Le Fort I osteotomy combined with sagittal split ramus osteotomy (SSRO) may include:
Swelling, asymmetry, bruising, infection, scarring, pigmentation, foreign-body reaction, pain, numbness or sensory change, hair loss, tissue necrosis, visual disturbance, facial-nerve injury, allergy, shock reactions, etc.
*Individual experiences and recovery times vary.
