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Functional Surgery Questions / Re: CCW rotation and stability
« Last post by Lazlo on Today at 03:44:13 PM »
Hey guys, so I went to my consultation with my surgeon and he said he doesn't do CCW because it's unstable and would be bad for my joints because of TMJ. He wants my ortho to remove two bottom teeth and push them back if possible so he can advance my lower jaw as well without ruining my lips. Thing is I feel like CCW will fit me the best and I've found a surgeon who has very good reviews but its all been for tooth extraction. I emailed him and he said CCW is a more unstable movement but he is willing to do it and it'll take more work. The one who doesn't do CCW has alot of good surgery rep. In this scenario what would you guys do? Keep in my mind I'm in Canada and tied to gov healthcare lol. Here's a pic of me


Dr. Stephen Ho in Mississauga Ontario specializes in CCW
What I see in the ceph is excess vertical down growth of the maxilla in the area of the upper central incisors and also some retro-inclination of them.

From a mechanical perspective, that would tend to act as a clasp to push your mandible backwards. I would attribute the retrusion of the mandible to it being clasped backwards by excess vertical down growth of an isolated segment of it. Segmental maxillary osteotomy looks to be a surgical option. 
is your lower jaw/arch narrow too?
this was Haers. Hes belgian and trained under Sailer, but works in the UK. Fwiw i've seen someone IRL he did jaw surgery on and she looked great, but rhino wise - a disaster for me
Oh well no surprise then, Sailer is shit at rhinoplasties unless it's something basic.
I have not yet seen a surgeon. I didn't no any of them did free diagnosis and treatment plans free of cost so that's interesting. If you don't mind me asking, who were they and how did you find them?

Functional Surgery Questions / Re: CCW rotation and stability
« Last post by XXRyanXXL on Today at 09:17:36 AM »
There was a post on here recently by member CCW who indicated that CCW rotation alone creates more airway room around the base of the tongue. But the Surgeon can always advance the whole MMC forward to create that space. Not sure about the tmj though, get an opinion through Wolford.

I'm getting CCW rotation in my next operation (my MP angle is 40 degrees, OP is 10) and I was advised my cheek pads look descended, and was suggested to get midface soft tissue suspensions. Maybe that's an option for you? These are interesting questions you are asking, I don't believe anyone on here can predict soft tissue changes and immediate bone structural issues you are inquiring about.

Have you seen an Oral and Maxillofacial Surgeon, or been evaluated by one recently? You can actually find some surgeons who are willing to give you a complete diagnosis and treatment plan free of cost. I've come across 3 surgeons.
I will try to upload some front and side pictures later. Not exactly thrilled about having my face plastered over the net but needs must I suppose.

Anything that is going to make my face longer will make me look worse as I already have a long face. Ideally increasing the width of jaw and cheekbones would help counter the excessive length.

Prof S said UK surgeons are something like 15 years behind German and Swiss, from the state of our GPs, I can believe it.
looks like Uk surgeons got the worst rep. Especially under the nhs never go for a rhinoplasty/septo.
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