Author Topic: Is my maxilla recessed/should I have had upper jaw surgery  (Read 9190 times)

jawprobs16

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Is my maxilla recessed/should I have had upper jaw surgery
« on: July 09, 2016, 09:19:32 AM »
Hello everyone. I had lower jaw surgery (BSSO) for my underbite and crossbite 3 months ago. At first I was supposed to have double jaw surgery because my teeth were not leveled. My surgeon and ortho deemed a 3 piece lefort unnecessarily risky (that was the only way to level the teeth) so they said they could easily level the teeth with orthodontics. After that, my surgeon said my upper jaw didn't need to be touched because everything was fine with it. Now, I feel like my upper jaw should have been worked on. I feel it is recessed and I have vertical maxillary excess, though I'm not sure if the gums showing are just due to inflammation of having braces for so long because before braves I did not have a lot of gum show. Do you guys think I have a recessed maxilla/should have had my upper jaw advanced? need honest evaluations! first ceph is before, last ceph is after surgery
« Last Edit: August 05, 2016, 05:58:18 AM by jawprobs16 »

Vic

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #1 on: July 09, 2016, 09:25:48 AM »
If you have a Ceph X-Ray to share, it would be easier for people to evaluate?

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #2 on: July 09, 2016, 09:32:38 AM »
They keep saying my jpeg image is too big

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #3 on: July 09, 2016, 09:44:47 AM »
here is my lateral ceph after surgery
« Last Edit: August 05, 2016, 05:58:35 AM by jawprobs16 »

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #4 on: July 09, 2016, 09:46:46 AM »
here is a ceph of me before surgery
« Last Edit: August 05, 2016, 05:58:46 AM by jawprobs16 »

Vic

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #5 on: July 09, 2016, 11:29:02 AM »
How many millimetres did they setback your lower jaw?

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #6 on: July 09, 2016, 11:59:01 AM »
6 mm

Vic

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #7 on: July 09, 2016, 12:29:19 PM »
Your bite looks really good now and it doesn't look like you have maxillary excess from your pic. The reason you might feel you can see gum might be due to the protrusion of the teeth making your lips curl. Doing a Lefort 1 to reduce the maxillary would also mean you have to have lower jaw surgery as well to rotate the lower jaw ccw, so your bite fits again. This will also make your face slightly shorter. If you are going to do surgery again, I would get the maxillary rotated cw as well as reducing the height, to get correct the protrusion of the upper teeth and remove the support of it pushing your lips up and out.
How long left have you got to have braces on?

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #8 on: July 09, 2016, 12:38:44 PM »
Probably 2 or 3 more months. So my maxilla isn't recessed? I still have a bit of a long face, but I don't know if it's worth another surgery. My surgeon said he didn't do the upper forward becaus she felt that it would push my nose and lips too far out since they already push out naturally. Overall, do you think I should or should I just leave it how it is?

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #9 on: July 09, 2016, 12:42:33 PM »
Also does it look I need a genioplasty?

Vic

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #10 on: July 09, 2016, 12:59:30 PM »
I can't make that decision for you, but your maxilla doesn't need to go forward at all because it's already protruding. It all depends how unhappy you are about it really, if you feel that your face is too long and you really want to change it, then go for the surgery. But it all depends on how badly you want it.

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #11 on: July 09, 2016, 05:36:30 PM »
Is my midface flat though? Because when I smile or laugh my chin looks so bulky?

PloskoPlus

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #12 on: July 09, 2016, 07:48:41 PM »
Tooth show, profile look good.  The chin is a bit rounded in profile, but it's normal for black people.  You could probably make it sharper with genioplasty, but I'm not sure if it would look good (would not fit your lips).  Was the frontal picture taken by a surgeon or orthodontist?

jawprobs16

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #13 on: July 09, 2016, 11:00:42 PM »
No I took it

PloskoPlus

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Re: Is my maxilla recessed/should I have had upper jaw surgery
« Reply #14 on: July 10, 2016, 02:47:20 AM »
No I took it
Bear in mind that I'm no doctor andd lens distortion from small cameras can make people look very different in selfies vs photos taken by a proper camera.

http://www.stepheneastwood.com/tutorials/lensdistortion/index.htm

 I think your main problem is not that your face is long, but that it's narrow which makes you think that it's long. Your cheekbones look deficient and you look narrow jaw angle to jaw angle from the front..
The cheekbones can be addressed with a zygomatic osteotomy. It mainly gives width and a bit of forward projection under the eye (which you could do with as well). The jaw angles could be improved with a chin wing osteotomy (the chin could be narrowed a bit at the same time).

 An alternative is implants. They can be made into any shape. The downside is quite a bit of foreign material in your face which could get infected even decades after surgery. With osteotomies, especially zygomatic, the result is highly predicated on your initial bone shape (but chin wings can be repeated multiple times to build up more and more bone where you need it, although resorption is a real risk). But the only foreign material  with osteotomies are the plates, which are highly unlikely to get infected and are easy to take out and can even be taken out as soon as the bone heals (a year after surgery).

Your nose is quite wide from the front (it should be within the inner corners of your eyes). Narrowing it would make your face look wider. Rhinos are seriously hard to get right, so it would be the last thing i would do and only with the best possible surgeon. A bad nose job can absolutely ruin a face.