Le Fort III and dual Le Fort I osteotomies for midface advancement and shortening

An adult patient’s posttraumatic tall, retruded midface was concomitantly shortened and advanced by combining Le Fort III/I osteotomy with maxillary impaction through excision of a horizontal subnasal bone sector. Exophthalmos, nasal shortage, malocclusion, and gummy smile were corrected; however, complications included asymmetric palpebral breaches. • Le Fort III/I can not only advance but also shorten the midface. • Doubling lower cut of Le Fort III/I permits reduction of tall faces. • Le Fort III osteotomy may risk resulting in asymmetric palpebral slits. • Neglected Le Fort III fracture may retain midface in undesirable retro-position.