Desperate Guy With Severe Issues Need Help

[Wicked Sick]

Hi there!

This is my first post on this forum. I am seeking help for my multitude of health concerns. This dental issue has ruined my life. I've been put on antipsychotic medication, have anxiety, depression, paranoia, eating disorder, deficiencies etc.
I didn't wanted to admit to myself, but the truth is that all of this is a result of the aesthetics of my teeth. I don't feel that I'm an ugly looking person, but when I try to interact socially and someone cracks a joke I rather just stare away smiling without opening my mouth. If I do open my mouth then I see others vanish their smile off their faces and become distant to me. Literally leave me there. I have included a picture of myself so you can tell your opinion regarding this.

I registered here to hopefully receive answers to some questions:

1. Can this be corrected without surgery? As far as I read I have severe anterior open bite and moderate-severe malocclusion. My chin seems to be receeding. Thought I would ask because these days you can do anything and create magic w/o surgery.

2. Would jaw surgery be needed first before surgery for ankyloglossia (tongue-tie)? I still have my tongue tie since birth and feel that if I'd do the surgery for it, then my mouth would not have enough room for my tongue. It is already big (my tongue) and when I try to extend it (wife  ) it hurts immensely.

3. Could you be so kind and rate the severity of my dental problems 1-10 in comparison to people you've seen here? Thank you!

4. I've read how these surgeries might not give you the results you wished for. Sure, you can have pretty smile, but it can completely alter your look. Like make your nose bigger and such. Does the surgery increase the distance between your lips and nose (philtrum)? I have an extremely long distance (0.8 inches) between my nose and lips (which I'm very self-conscious and aware of) and I hate it. Have read some horror stories here of some good looking people with bad teeth became "average" or below average looking with the classic American smile to compensate for some of the loss.

Thank you very much for any future help!

Finally, the picture:


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[Optimistic]

Proof of how f**king insane psychologists are. It's an unscientific cult full of marxists. God they piss me off.

The fact you got put on meds instead of being given REAL ADVICE on fixing the cause of your problems is mind boggling. I mean, who would've thought mental anguish isn't solely caused by some lofty sense of self worthlessness. How crazy that it could be the result of physical or mental traits which negatively affect our lives, because after all, we are social creatures who just want to be accepted.

f**k them. I hope they burn in Hell with the havoc the wreak. Fun fact: Practically every mass murderer of late has been on anti-depressants and s**t because some c*nt of a female marxist psychologist put them on it instead of actually sorting them out or admitting them.

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1. Yes, you are quite right that most things can be corrected without surgery. Unfortunately this doesn't mean one ought to do so. There are significant trade-offs when opting for a purely orthodontic resolution. Often you'd be looking at a very long time in braces, extractions, TADs, and other such things to get the occlusion to a halfway acceptable position without any regard for aesthetics.

By opting for a surgical approach you'll be able to get a proper bite along with address the skeletal deficiencies that are likely to have caused your malocclusion.

2. I have no idea what that is and I'm too lazy to google it. Sounds like you mean you have narrow palate and may need SARPE or something prior to bimax.

3. Pretty f**ked up/10

4. Some of your concerns are valid albeit misplaced. The nose can widen with a le fort, however this can be prevented to a large degree with an alar cinch. Generally maxillary advancement makes the nose look smaller as "big noses" are usually no big, rather the maxilla is recessed creating that illusion. If you have a long philtrum this could be genetic, or it could be because your maxilla is recessed and so it's flat. So surgery will almost certainly improve that aspect.

Honestly, I haven't ever seen results where someone looked worse afterwards. I've seen ones with bad bites, but when one has a skeletal deficiency that is being addressed it's pretty much impossible to look worse.

In my experience most complaints are from people who can't adapt to their new look, even if it is better. Rather than them looking objectively worse. Not saying it has never happened, but it is very much the exception and not the rule.

[Gregor Samsa]

Your upper jaw looks very narrow. You should definitely see a good surgeon if you can and I wouldn't be surprised if they recommend the SARPE procedure. Where do you live? I'm sure someone here can recommend a good surgeon near where you live.

[PloskoPlus]

The chances of you fixing this without surgery are slim to none.  I'm afraid you're gonna have to bite the bullet on this one.

[sean89]

As an absolute minimum, you are going to need SARPE and braces.

If you want to fix it, you will need to see both a maxfac surgeon and an ortho.

If you are from the UK, I suspect you will be able to get NHS treatment for your teeth and so you should go and see your local dentist first and ask if you can be referred to an orthodontist, even though you look older than 18 (cut off point I think).

If you are private, you really need to see an ortho straight away to get it fixed as soon as possible.

You are right in the sense that, facially, you are not bad-looking, but your teeth do need fixing and the quickest way to do that is to speak to an ortho as soon as you possibly can.

[Tiny]

Yup....looks like you need surgery...probably SARPE and bimax.  Maybe you can get a multisegment lefort but I think most surgeons do SARPE these days instead

Some orthos like to think that they can fix anything without surgery.  They can't.

[Wicked Sick]

Wow! I'm so thankful for all of your replies!!! 
Yes, I live between Central-Europe and the US (my wife is american). I'm 26 years old by the way.
At the moment I cannot afford any kind of surgery. Here is another picture included.
I really appreciate all the comments! 


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[Gregor Samsa]

If you have health insurance in the US then maybe you can check if it covers jaw surgery? This kind of surgery is usually paid for by the state in most European countries if it's deemed necessary for you so if you're a citizen in an European country then you should try to get it done through the national healthcare system. If you're flexible enough to be able to get it done in either Europe or the US then you get to pick from all the best jaw surgeons in the world so you're "lucky" in that regard.

[Wicked Sick]

That's the main problem. Who could I find with insurance? I mean is it a person who does these correcitve surgeries on a regular basis not really caring about the outcome, or should I go for somene who asks a price in 5 digit number and does the job well? To be honest: I really want to have a once in a lifetime experience with jaw surgery. I know lots of people have to take numerous surgery because it doesn't come out perfect, but if I have the chance then I would go for the very best! Besides after all this suffering I was playing with the idea of the outcome. I could look like life intented me to look like (minus the dental problems) or I could opt for a jawline of a male model. 
I would not try to modify my aesthetics if surgery would be inevitable, but since I would have to go through years of wearing braces, risking not being able to speak normally ever again (tongue tie surgery) and all the depression I've dealt so far I think my wish is fair.

[Gregor Samsa]

People usually try to find a surgeon close to where they live. Maybe ask an orthodontist and see if they can recommend someone. Your insurance company probably won't allow you to go out of network anyway so you might be limited to a local surgeon unless you want to pay for everything yourself. Many of the "top" surgeons in the US don't even accept insurance though. The situation is a bit easier if you live in say Germany since all the hospital costs are regulated there.

Finding a good surgeon is not always easy and sometimes they do make mistakes. Normally we advice people to seek as many consultations as possible before they decide on a surgeon but it might not be possible in your case if you can't afford all the consultation fees. If you do manage to see a surgeon and get a surgery plan then you can return to this forum and let some of the more knowledgeable members here see if it makes sense (I'm not one of them).

[Wicked Sick]

Awesome information! I thank you very much and will return here sooner or later! I understand that this condition will affect my breathing so I will be proactive about this.

[LoveofScotch]

Hey Wicked Sick,

Twice now, you've mentioned tongue tie surgery. Sorry, for my ignorance, but what's that? Who suggested that you need it, and why was it recommend?

[Wicked Sick]

Sorry about that! I wanted to explain, but forgot about it. Here: http://en.wikipedia.org/wiki/Ankyloglossia
Be sure to watch the video as well as how relieving it is for an adult (they usually do these surgeries for babies because it's an inborn error): https://www.youtube.com/watch?v=Un21c9t5toE

Sadly I can't do this yet, because my tongue is too big even being tied. 

[LoveofScotch]

Oh, yikes. That sounds super problematic!

How have you been managing so far? (It seems like it's often corrected a lot earlier in life.) What symptoms/issues do you have because of it? Also, you can't do anything about it, right now, because your tongue is too big? What?

[Wicked Sick]

Thank you for all the comments and suggestions! So I've been reading more and more about surgery and I'm tending towards doing this as soon as possible. I will seek a professional to have a general idea of the procedures need to be done, but so far some of you mentioned SARPE and Bimax.

So which one comes first? How risky are these surgeries? Looked up SARPE and some people even do it without being put to sleep. How many years would all these procedures and follow ups would consume up from my life?

I feel horrible. My wife is so beautiful and we look so odd on pictures. She has the perfect American smile and I never want to ruin the pictures so I just keep my mouth shut.  When it comes to being handsome teeth are EVERYTHING.
I also think that I have long face syndrome.