How to make a sleep apnea surgery look good?

[molestrip]

I visited a few world class surgeons. Some recommendations were the same, some were different. One surgeon recommended cheek implants and shortening my upper jaw, others did not. All recommended genioplasty. All recommended 3-piece LeFort but one. Otherwise, the plans are about the same. Thoughts? Given that they're all from highly respected surgeons, I'm inclined to go with a mainstream recommendation. But who knows, that could also be what makes that guy special, right?

[PloskoPlus]

I visited a few world class surgeons. Some recommendations were the same, some were different. One surgeon recommended cheek implants and shortening my upper jaw, others did not. All recommended genioplasty. All recommended 3-piece LeFort but one. Otherwise, the plans are about the same. Thoughts? Given that they're all from highly respected surgeons, I'm inclined to go with a mainstream recommendation. But who knows, that could also be what makes that guy special, right?

What do you look like right now?

[molestrip]

Emailed a link. Anyone else interested let me know.

[dantheman]

Some details must be missing to your story.

You have documented sleep apnea (presumably), given the title of your thread.

The surgeons recommend genioplasty, cheek implants, and shortening to upper jaw.

These are NOT treatments for OSA.

Please enlighten us.

[molestrip]

Vertical shortening. Horizontally they'd come out.

[PloskoPlus]

Emailed a link. Anyone else interested let me know.

BTW, how's your bite, smile?  Those are very important too.  Don't tell me you'll have surgery without braces.  BTW, your upper lip is quite long.  A large maxillary advancement may lengthen it further.  In any case it will probably appear longer, even if it's the same length post-op (objects closer look bigger).  You ought to keep this in mind:
http://imgur.com/ezpiEZc

[molestrip]

Plan is 10-12mm CCW rotation to mandible and 6mm forward to maxilla, 4mm posterior down, and 2mm anterior down w/3-piece LeFort, and 5mm sliding genioplasty. Alternate recommendation is to leave maxilla where it is and do a VY-lip lift I think to show some teeth with cheek implants.

[PloskoPlus]

Do you have an open bite?  In that case you will need surgery regardless.  Your upper lip is long. Your eyes are closer together.  A very big upper jaw advancement may make you look simian.

[molestrip]

Yes. My open bite is only 2mm right now but that's because my wisdom teeth and molars are heavily worn, causing a lot of sensitivity. I'm told I need to fix them but can't without opening up my bite a lot. My open bite would become 5mm+. Anyway, my jaw is really tired of not being able to close comfortably.

Do you recommend the lip lift then? I would ask the surgeon not to tip the maxilla down then. Is my maxilla advancement big enough to make me look simian? That's why one surgeon recommended cheek implants but I've heard that will make my eyes look even more narrow. What do you think? If both are risky, then I'd rather not have the extra work done.

[molestrip]

To revive an old thread, the teeth on the lower jaw would be advanced 10mm (13mm to chin). The maxilla will drop 4mm in the back to level it out, slide forward 4mm behind the nose, and 6-7mm forward at the teeth tip due to rotation. So as I stated in another thread, I'm concerned about the aesthetics of advancing behind the nose but I'm guessing this isn't enough to be a problem. I'm more concerned about the protrusion of my upper teeth causing a simian look. Thoughts and options?

Trouble is, I don't have a weak chin so I don't benefit much from the CCW. Perhaps I'm misreading the plan though. Can someone help me interpret it? Send me a PM and I'll post a link to the plan. Thanks!