The maxilla can be adjusted using a Lefort I level osteotomy (most common).

Cutting the bone is called osteotomy and in case of performing the surgery on the two jaws at the same time it is called a bi maxillary osteotomy (two jaws bone cutting) or a maxillomandibular advancement.

Sometimes the midface can be mobilised as well by using a Lefort II, or Lefort III osteotomy.

Sometimes the pulse cannot be taken at the wrist and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries.