Short Upper Lip -- "Gummy Smile" Le Fort 1 Segmental Osteotomy Correction

This 20 year old female complained of a short lip causing inability to close the lip completely resulting in a "gummy smile". On examination, excess of vertical height of upper jaw or the maxilla was observed. The aim of correction is to reduce the vertical excess of the upper jaw so as to create normal smile for the patient.
After adequate study, under general anesthesia and standard preparation, through the mouth the surgery was carried out. Surgical incision was placed in the upper vestibular and nasal mucosa till the pterygoid region. The jaw bone is exposed. The Le Fort I standard cuts were placed using saw.  Using septal divider, the septum was disengaged. Spreader was used to split the cuts. Down fracture of the Maxilla was performed.
Excess of the vertical height of 10 mm was reduced along the all related areas appropriately. Part of the nasal septum was also removed as a normal septum would bend after approximation of the maxilla creating a compromised airway. After this the maxilla is shifted upwards. Bone fragments were fixed with plates and screws. While closing the incised area, alar base sinch was secured so as to prevent the nasal alar base appearing wider.
The initial healing period is for two weeks. A normal smile was created for the patient.