In this injury the break runs horizontally above the roots of the upper teeth, cutting the tooth bearing jaw free from the rest of the midface. The cheekbones and eye sockets stay where they are, while the palate and upper teeth move as one loose block.
A Le Fort I fracture separates the lower part of the upper jaw, the part carrying the palate and the upper teeth, from the rest of the face. The bite is the main casualty, because the freed block drops or slides back and the teeth no longer meet correctly. Treatment restores the bite first, then holds the jaw with small plates along its supporting pillars.
The upper jaw is not a solid block. It is a shell of bone around the sinus, supported by vertical pillars that carry the force of chewing up into the skull. When a blow lands on the upper lip and teeth, the shell can shear across just above the tooth roots. The line runs backwards from the base of the nose, through the side walls of the sinus, to the back of the palate.
What comes free is the palate together with the upper teeth. Grasping the front teeth and feeling the whole upper arch move while the nose and cheekbones stay still is the classic finding. Above that line, everything remains attached to the skull, so this level does not usually disturb the eyes, the cheek prominence or the shape of the nasal bridge.
The trouble is felt in the bite. That block often slides backwards and downwards, leaving the back teeth meeting early and a gap at the front. Patients describe teeth that no longer fit, difficulty biting into food and a bruised palate. Bleeding from the nose is common, since the sinus lining tears along the fracture line.
Fixation is advised when the freed jaw has moved enough to disturb the bite or when it is clearly mobile. A small number of cracks that have not shifted can be managed without an operation.
Your bite, jaw mobility, teeth and airway are examined and a computed tomography scan maps the fracture line. Photographs and any earlier dental records help define what the bite looked like before.
Under anaesthesia, the upper and lower teeth are brought together into their earlier relationship and held there with arch bars or wires. This step decides the position of everything that follows.
Through a cut inside the upper lip, the front and side pillars of the upper jaw are exposed. No cut is made on the face, so healing leaves nothing visible on the skin.
Small titanium plates and screws are fixed across the fracture on each side, along the pillars that carry chewing force. The jaw is then stable enough to hold the restored bite.
Wires holding the jaws together are usually released before you go home, with elastics used for guidance. Reviews check the bite, healing of the gum and your return to a normal diet.
Facial swelling and nasal blockage are at their height. Pain relief, mouth rinses and a liquid diet are the mainstays, and the head is kept raised.
Swelling settles noticeably and gum stitches dissolve. Elastics may guide the bite, and food moves from liquids to a soft diet under advice.
The fracture has united and the bite feels reliable. Chewing gradually returns, though hard and chewy food is still avoided for a while.
Numbness of the upper gum continues to improve. Any small remaining bite discrepancy can be reviewed with a dentist and adjusted if needed.
When the bite is restored early and the pillars are plated well, most people chew comfortably again and the face regains its earlier proportions. Small differences in how the teeth meet can remain and are often settled with minor dental adjustment. Numbness of the upper gum and teeth improves slowly over months. Where teeth were lost or broken in the accident, further dental work is usually needed to complete the result.
This is established surgery for a serious injury, and the following risks are explained before you consent.
Diet and mouth care do most of the work at home, and both protect the bite you were given in theatre.
Plates now carry the load, so wiring is usually released before discharge. Guiding elastics may stay for a while, which still allows speech and a soft diet.
Teeth can look untouched while the whole tooth bearing block has separated above them. A changed bite is the more telling sign.
The bite set at surgery is the bite that heals. Any change noticed afterwards needs review early, while adjustment is still straightforward.
At this level the eye sockets stay attached to the skull. Vision and eye position are usually normal, which is what separates it from the higher patterns.
Midface injuries at Elegance Clinic in Surat are planned around the bite rather than around appearance alone, and imaging is discussed with you and your family before the operation is scheduled.
Charges depend on how many plates are needed, the theatre and anaesthesia time, imaging and the length of your stay. Jaw fracture fixation is the closest guide to the range, and the band shown below gives a fair idea of what such surgery usually involves. A written estimate is prepared once the scan has been reviewed. Accident related fixation is normally covered by mediclaim, and the team helps assemble the paperwork.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →Fixation of this kind usually falls in a band of Rs 55,000 to Rs 1.2L, depending on the number of plates, theatre time, imaging and how long you stay. A written estimate is shared once the scan is reviewed so the figure matches your plan.
Fracture fixation after an accident counts as reconstructive rather than cosmetic surgery, so most policies consider it. Claims usually need accident records, the scan report and operative notes. Room rent limits and waiting periods written into the policy still apply.
It is performed under general anaesthesia with the airway protected throughout, and the approach through the mouth is well established. Bleeding, infection of a plate and numbness of the upper gum are the main risks, and all are discussed before you consent.
Swelling eases over two weeks and liquids give way to soft food. Bone unites at around six weeks, when chewing gradually restarts. Light work often resumes in three to four weeks, while heavy or outdoor work waits longer.
The bite is set in theatre to match how your teeth met before the accident, and most people chew comfortably once healing is complete. Small differences can remain and are usually settled with a minor dental adjustment afterwards.
Only when the block has not moved and the bite is unchanged. Those patients are watched with a soft diet and review. A mobile jaw or a changed bite needs fixation, otherwise the bone heals in the wrong position.
Usually within the first week or two, once other injuries are stable and swelling has begun to settle. Earlier repair makes restoring the bite easier, because the fragment still moves freely at that stage.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
