Surgical treatment of midface deformities.

Midface deformities may be treated either by osteotomies that advance the maxilla or by osteotomies that retract the mandible. A transfacial technique is presented by which the cheekbones, the infraorbital rim, and the superior dental arch are advanced. The indications for this intervention are more widespread than those for Le Fort I osteotomies or mandibular osteotomies. Postoperative complications and risks of recidivism are reduced for this method because of the use of small screw-on plates for frontomalar osteosynthesis. Fifty-two cases of osteotomy are presented with special consideration of problems caused by bone grafting and postoperative occlusion and with a discussion of the factors responsible for relapse.