Will I look better?

[deyapretty]

Hello!

I didn't know where to post this so I picked the "others" subsection.

I took an appointement to a maxillofacial surgeon and he said that I would need

orthodontics with extractions to push the upper and lower teeth backwards with the lower teeth needing to be brought even further backwards which then would be brought back to the front with surgery.

lower jaw surgery to bring it forward

chin osteotomy to correct the receiding chin

Le Fort I osteotomy to bring the upper jaw a little closer to the nose to correct the length between my lips and nose and that would also correct the lip strain (and chimp mouth) and the slight gummy smile.
(see pictures below)

He said to me that I was a mouth breather at night and it would lead to more and more complications. Also, he said that according to the position of my teeth (see radiography) they would soon or late start to get loose, especially the lower teeth 

So there are esthetical and "health" matters here.

Knowing that this will cost me time and money is that going to make me look better?
I'm afraid it will lead me to a very flat profile (maybe a little concave as well?) due to the extractions matter... I DON'T want my healthy teeth to be extracted.

What do you guys think?

Thank you

[Tom2]

That is a crap load of work for what benefit?

Now I say that knowing I just had all that done save the pulling of teeth but I was a hell of a lot worse off than you.

I was fugly.    You are not.   Not even close.

The health risks are a potential but I would look into methods of avoiding those possibilities before I put myself through that you are talking about.    Hell I waited until I was in my 40's and just couldn't avoid it.   And I still don;t know if the surgery was worth it.....(ask me in about 10 1/2 months and I'll let you know.   

 Read up on the risks of what was proposed to you.

[PloskoPlus]

Your smile does not look particularly gummy.  Quite normal for a woman, in fact.  Your ip incompetence MAY improve with just a sliding genio.  You need to consult more surgeons.

[deyapretty]

Thank you for your advice Tom2.

The surgeon didn't tell me about the risks because I just went to see him for advice. He suggested I took an appointment with an orthodentist (which I did).

Seriously I'm not pleased with my looks and find myself incomfortable looking at pics of myself (is that really me???).
I think I look much older with those sagging lines below the eyes and at the corners of the mouth and I know that surgery has a chance of making me look better.

I tried some retouching of my face on photoshop and I don't know which one would be the most accurate.





@PloskoPlus
Turns out he's the best one in Paris. He has a very good reputation. I waited 4 months to get an appointment :/

[PloskoPlus]

Just because he's the best in town, doesn't mean he does everything.  For example, only a handful of doctors in the world do ching wing osteotomies (maybe applicable in your case).  Yet for most cases where a genioplasty is required, they are superior.  Only a handful will do high Le Forts (not applicable in your case).  etc..

[deyapretty]

Well he's not just the best in "town", this is Paris.
Anyways 
He told me that I would also need a Le Fort I... is that what you mean by "high Le Fort"? It would make sense since my mouth-to-nose ratio is too big for my taste.

[GJ]

I deleted your duplicate thread and moved the old one here for you.

Why did the ortho say your teeth would become loose?

[PloskoPlus]

I deleted your duplicate thread and moved the old one here for you.

Why did the ortho say your teeth would become loose?

Maybe the bottom are tipped forward (compensating).  A surgeon once told me that class II is actually worse than class III in terms of long term stability, but class III is more likely to be fixed because it's less socially acceptable and you can jut the lower jaw in class II to mask it.

[deyapretty]

Maybe the bottom are tipped forward (compensating).

Exactly they are like this:




Also, I really don't want to end up like this. Is there a chance?


I retouched it on photoshop and did what the surgeon recommended for my face (pull the teeth back, move the lower jaw forward with a chin osteotomy to move it forward and a Le fort 1 to adjust everything and to bring the upper jaw a little bit closer to the nose.

[Serra]

I had an open bite, had lower jaw surgery + chin surgery and I'm left unhappy.

I don't think you need surgery.

If I were you (and what I wish had done for myself) I would get miniscrews/temporary anchorage devices to intrude my upper molars and close the bite. Your mandible will auto-rotate forward.

Here is an example, but this is an extreme case with lip protrusion and extractions:

http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=3380&Type=FREE&TYP=TOP&IN=_eJournals/images/JPLOGO.gif&IID=262&isPDF=NO

I don't support extractions except maybe in cases like this.

[Serra]

Exactly they are like this:




Also, I really don't want to end up like this. Is there a chance?


I retouched it on photoshop and did what the surgeon recommended for my face (pull the teeth back, move the lower jaw forward with a chin osteotomy to move it forward and a Le fort 1 to adjust everything and to bring the upper jaw a little bit closer to the nose.

Yes, I think there is a chance. You don't really have a weak chin IMO. Don't be me where I had chin surgery, hated it and sought to reverse it, and did surgery to "reverse" it but the surgeon just did whatever he wanted to reduce it a little bit.

[deyapretty]

@open_bite

So you are suggesting orthodontics without extractions?

In any case that won't correct my long face. :/
The surgeon suggested the LeFort I + the sliding genio.
Can it look that bad? :s

I'm afraid of the result on the picture if they flatten my teeth. Do you think that with orthodontics it may look like that?

[Serra]

@open_bite

So you are suggesting orthodontics without extractions?

In any case that won't correct my long face. :/
The surgeon suggested the LeFort I + the sliding genio.
Can it look that bad? :s

I'm afraid of the result on the picture if they flatten my teeth. Do you think that with orthodontics it may look like that?

Sorry, I didn't see your post until now.
Please check out my other posts about miniscrews/TADs and bring them up to various orthos. You'll find links I posted - you can achieve a small reduction in facial height with them. The case I posted has extractions but try to push for no extractions...

I honestly don't think your case warrants jaw surgery at all. You have no idea what you're getting into if things go wrong, and a s**t ton of things can. Many surgeons do not warn you of possible complications, and we always think our surgeon is a special flower who can do no wrong when we're pre-op. With genio alone, the soft tissue complications I've encountered are mentalis strain/severe chin wrinkling (which I never had before), chin muscle drooping, crooked lip possibly due to nerve damage... And I'm not even getting into the bone problems.

It really irks me when people who are close enough to ideal want to do this surgery. From your xray, your upper molars can be intruded via TADs to close your bite, auto rotate your mandible up and alleviate your lip strain. I really wish someone told me all this stuff I'm telling you before I had the surgery.

[deyapretty]

I have an appointment with the orthodentist in 2 weeks. I'll see what she offers me to do. I'll try talking to her about miniscrews... though will it be visible whatsoever? I mean I'm actually in a job search and don't want my looks to be affected in case I get any interviews 


This is another picture I just edited. I didn't hide my face this time and that's why I won't let them online for long... but it was just to show you how I could look if i got surgery... in my opinion I would be 10 times better and would be much more confident.
I don't know... sometimes I think it's worth the try, isn't it? (<-- if I end up looking like on the right)

[Serra]

I have an appointment with the orthodentist in 2 weeks. I'll see what she offers me to do. I'll try talking to her about miniscrews... though will it be visible whatsoever? I mean I'm actually in a job search and don't want my looks to be affected in case I get any interviews 


This is another picture I just edited. I didn't hide my face this time and that's why I won't let them online for long... but it was just to show you how I could look if i got surgery... in my opinion I would be 10 times better and would be much more confident.
I don't know... sometimes I think it's worth the try, isn't it? (<-- if I end up looking like on the right)

Yeah, morphed pictures of our profiles always look good but no one can show you a picture of how your face will change from the front.
I have a good profile now, but look weird/long from the front, and not in a good way.

Miniscrews shouldn't be visible anymore than normal braces would be. They go in your gum tissue temporarily.
Can we see your smile from the front? Just the mouth is fine.


While your plan is better than mine was for an open bite (I had BSSO + SG), you also have to take into consideration upper incisor show/gumminess and your nose. I don't know, some people don't seem to have much change in their nose from a lefort and then there are others who are very unlucky. I had double jaw surgery proposed to me, but said no after I had been previously told I shouldn't in my case (no gum show). From what I see of your nose, it's upturned already with a lot of nostril show so if you're unlucky you might get a pig nose. If you don't have a gummy smile, I'd advise against the surgery and trying to go for tads.

Oh and if you insist on surgery, please don't do SG. Your chin should rotate more forward if you do do a lefort. I think your chin would become too strong with an SG and the other risks are not worth it. Life is very hard for me suffering from these complications.