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Good question!
LeForts come in all shapes and sizes. A posterior impaction is indicated when their is a steep palatal plane. This shows excess vertical bone in the posterior of the maxilla – the surgeons have to have something to cut down in order to do the impaction. I look at this case and think of a multipiece LeFort with anterior downgraft splitting with the posterior impaction. The multipiece will help treat the asymmetry.
KEY THING: Don’t forget that there is no such thing surgically as a straight up or down LeFort. Once the surgeons do the downfracture they will have about a 2mm advance just to be able to clear the pterygoid plates. Also even though technically a LeFort “setback” is possible (cutting out a ridge of the palate) it’s not realistic. I’ve worked with over a dozen orthognathic surgeons and I’ve met only one that did the surgery one time (in a very long career) and he said he’d never do it again.