BSSO alters the mandible attachment point?

[Questioning_Options]

I recently visited an cranio-facial surgeon to ask about issues related to maxillary hypoplasia (teeth crowding, grinding and pain, shifting, gum recession, etc.). When I asked about palatal expansion, she told me that it would cause my upper jaw to not align with my lower jaw. I responded with what I thought should have been an obvious understanding for her: It would have been double jaw surgery, with something like BSSO or a ramus osteotomy on the bottom. She said that BSSO would cause my jaw to be too wide to attach to my face.

The whole visit felt pointless, and she was not very helpful at explaining things. The idea of a procedure like BSSO causing mandible attachment issues is new to me. I've never heard it discussed in these kinds of forums. If that is true, it would seem to indicate that the way mandibular procedures are discussed on this forum is very wrong. Am I missing something?

[PloskoPlus]

Never heard of this. Craniofacial surgeons are not naxillofacial surgeons anyway. They deal mainly with the upper part of the head.  You'll find a lot of plastic surgeons are also qualified craniofacial surgeons.

[Questioning_Options]

Never heard of this. Craniofacial surgeons are not naxillofacial surgeons anyway. They deal mainly with the upper part of the head.  You'll find a lot of plastic surgeons are also qualified craniofacial surgeons.

She dealt with orthognathic and jaw surgery, so she should have known about these issues.

Maybe she means it would look very odd on you... out of place. Some surgeons are terrible at explaining. Some of my consultations felt like I was literally throwing money down the drain. I think all of them should be using imaging software by now.

No, she was clear that what she meant was that the joint would not fit together after a BSSO surgery. Why would she say such a thing? Is that how it works?

[PloskoPlus]

She dealt with orthognathic and jaw surgery, so she should have known about these issues.
No, she was clear that what she meant was that the joint would not fit together after a BSSO surgery. Why would she say such a thing? Is that how it works?

Maybe she meant the lower jaw would have to be widened to follow the upper jaw... Anyway, this is theoretical.  Usually the upper jaw is widened or narrowed (my case) to fit over the lower.  If it already does, no expansion is done. 

Some surgeons in Europe do widen the lower arch, but AFAIK only when it looks like a horror show, and it's not a very stable operation anyway and puts too much pressure on the jaw joints.