Double jaw surgery case

[chocostar]

Hi, i'm just wondering what you thought of my case and what possible surgerical procedures could help me? I have an underbite and am currently in braces. I was told at one of my consultations that I would require double jaw surgery. I had read a lot about the types of upper jaw surgery but I was told something about a 'Kufner' procedure - from what i've read this is someone who modified a Le Fort? I believe in my case it would involve bringing not just the maxilla forward but the midface area too? There is additionally the possibility of cheek implants. I guess it's too early to know exactly what i'll end up having as I haven't been in braces that long.

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[chocostar]

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[PloskoPlus]

Did they say upper jaw impaction too?

[chocostar]

Does that mean removing bone? If it is, i'm not sure I just know the maxilla will be brought forward and mandible moved back. I asked if they thought I showed too much gum when I smiled and they said no.

[PloskoPlus]

Does that mean removing bone? If it is, i'm not sure I just know the maxilla will be brought forward and mandible moved back. I asked if they thought I showed too much gum when I smiled and they said no.

Hard to tell from the photo, but I think you do show a bit too much gum.  Can also be remedied by laser gum contouring.

[Tiny]

I think, if I were you, I'd see if you could get away with a le fort and genio instead of bimax.  Your underbite isn't huge and while your chin is big/long your lower jaw doesn't look massively out of proportion so a bigger movement of the maxilla (plus a reduction genio) might be a better option for you than smaller movements of both

If you were a woman I'd probably say go with bimax

[PloskoPlus]

I think, if I were you, I'd see if you could get away with a le fort and genio instead of bimax.  Your underbite isn't huge and while your chin is big/long your lower jaw doesn't look massively out of proportion so a bigger movement of the maxilla (plus a reduction genio) might be a better option for you than smaller movements of both

If you were a woman I'd probably say go with bimax

BSSO supposedly can improve gonial angles. No idea how, but I keep hearing this.  OP's lower jaw looks a bit steep. Amore horizontal mandible can look just as big, despite being shorter.

[Tiny]

BSSO supposedly can improve gonial angles. No idea how, but I keep hearing this.  OP's lower jaw looks a bit steep. Amore horizontal mandible can look just as big, despite being shorter.

Yeah good point, it is steep

[PloskoPlus]

Yeah good point, it is steep

I still don't understand how it could without rotating the jaws up.

[chocostar]

Thanks for the replies so far. I believe the modified le fort-type procedure my surgeon suggested would go quite high high up, including the lower eye socket area I think. I suppose it will also be key to find out when i'm closer to surgery the distance both the jaws will be moved, i.e. will one be moved more than another. Here is my x ray taken before I had braces put on.


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[chocostar]

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[Tiny]

Thanks for the replies so far. I believe the modified le fort-type procedure my surgeon suggested would go quite high high up, including the lower eye socket area I think. I suppose it will also be key to find out when i'm closer to surgery the distance both the jaws will be moved, i.e. will one be moved more than another. Here is my x ray taken before I had braces put on.

You need CCW rotation.  Hope they're planning it?

[dantheman]

2 amateur observations:

1. The maxilla appears deficient, which is likely a large contributor to the jaw imbalance.

2. Your head posture is downgazing. If one looks at the angle of sella-nasion or the plane of the nasal spine, the are tilted forward and down. This might just be your head posture for the ceph, but it makes the mandibular plane look steeper than it otherwise would.