Correction of Vertical Excess of the Lower Face

ABSTRACT

Since Wilmar first described term "Long face", various methods have been performed to enhance features of the patients with vertical excess of face, but Kawamoto established that the sole method to correct these deformities is to shorten the height of maxilla by LeFort I osteotomy. Features of the lower long facial pattern, conveniently called "Long face syndrome", "Horse face" has following characteristics; 1) Disproportionally elingated lower half of the face. 2) Widely separated lip and visible anterior teeth. 3) Hyperactivity of mentalis muscle. 4) The smile is typically "Gummy" 5)On profile, convex dorsum of nose, and receded double bump appearance of chin. 6) Tendency of class II malocclusion. From May, 1994 to April, 1999 we have treated 6 cases of vertical maxillary excess, "Long face syndrome" patient using maxillary LeFort I osteotomy and ancillary mandibular surgery. Sometimes there were combined bimaxillary prognathi and hemifacial hypertrophies. Age varied from 22 to 31(mean 23) and follow-up period varied from 6 months to 3 years(mean 1 year). Vertical shortening, rotation of the maxilla and combined mandibular adjustment surgery resulted in good facial harmony improvement of characteristics above and satisfaction of the patient with long face syndrome.