Author Topic: Regret double jaw surgery and genie for open bite and retrognathia  (Read 425 times)

kavan

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #15 on: October 26, 2017, 07:57:26 PM »
So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.

For too much anterior gum show and long front teeth with that, they can do an anterior impaction which IS CCW. Although posterior downgrafting also is a method for CCW in cases where the anterior maxilla can stay pretty much as is, if you look at her before photos, she also has posterior gum show. So, posterior downgrafting would just give MORE of that.

As to 'hyper mobile' lip, it looks like she is altering her lip posture in the last photo she gave, perhaps to hide what looks to be some kind of hardware or braces in her mouth.
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some1afterall

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #16 on: October 26, 2017, 09:30:29 PM »
Thanks for your replies, they have given me things to think about.

PloskoPlus

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #17 on: October 27, 2017, 03:13:00 AM »
Vertical changes from the front can be very hard to adjust to. I think your result is quite good.

tdawg

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #18 on: October 27, 2017, 05:24:19 AM »
Also another thing to consider is that in the photo you most recently posted you are wearing a hat and a hood, which hides your hair and I think has an aging effect. I think your result is probably as good as you could get with the typical approach that most surgeons take.

some1afterall

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #19 on: October 27, 2017, 07:39:34 AM »
here's a post djs/genio/braces pic from front with hair.

kavan

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #20 on: October 27, 2017, 01:28:07 PM »
here's a post djs/genio/braces pic from front with hair.

OK. So that shows an improvement to the gummy smile and better balance. The chin does not look 'long' either. You just got 'used to' looking at it when it was RECEDING into the background in frontal view. It's just more prominent in the foreground which is just a universal law of perspective where objects brought CLOSER to view will look larger than they did when they were further away. There is nothing aesthetically 'objectionable' to 'regret' with where your chin is now.
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girl

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #21 on: October 28, 2017, 01:03:26 PM »
You look nice in this picture.

As you didn't get the SARPE done, I would consider adding some veneers to the back to reduce the buccal corridors. That might make your face seem less "long" to you as well.