An overview is presented of new and modified techniques of repositioning and stabilizing the maxilla by the Le Fort I downfracture technique. Osteotomy design, anatomical considerations, sectioning of the maxilla, and neuromuscular rehabilitation are discussed, and rigid fixation utilizing a new mini bone plate system is described. Several case reports are presented which illustrate the use of Le Fort I osteotomy and other adjunctive surgical procedures in treating patients with dentofacial deformities and mandibular dysfunction.