Distraction of the Midface: Le Fort III and Monobloc

  • Joseph G. McCarthyEmail author
  • Roberto L. Flores


Gillies and Harrison [1] reported the first Le Fort III advancement osteotomy, which underwent relapse, and Gillies vowed never to repeat the procedure. The technique was later refined and popularized by Tessier [2] who placed iliac bone graft between the separated bony segments and performed the intraorbital osteotomy posterior to the medial canthus. The technique was eventually promoted and practiced in the younger patient [3]. The monobloc acute advancement was reported and popularized by Ortiz-Monasterio et al. [4]. However, in the Le Fort III/monobloc acute advancement osteotomy, there were multiple problems. Bone grafts had to be harvested, and there was a hardware burden, including maxillomandibular fixation (MMF). The infection rate was relatively high, especially in the monobloc procedure. Overall, these procedures had a high morbidity rate with a prolonged operating time and hospital stay.


Obstructive Sleep Apnea Orbital Floor Distraction Device Syndromic Craniosynostosis Lateral Orbital Wall 
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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Wyss Department of Plastic SurgeryNYU Langone Medical CenterNew YorkUSA

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