Correction of unaesthetic nose and nasal base fullness after LF1

[jaws]

A&G say that a large straight maxillomandibular advancement is associated with unsightly fullness at the base of nose, upturned tip of nose, saddle deformity of the nasal bridge, and lack of upper lip curve.

The patient below hasn't had an orthognathic surgery but his nose and nasal area is similar than in the previous example. It seems that nose augmentation can improve facial harmony after an unsuccesful LF1.

[Gregor Samsa]

A&G say that a large straight maxillomandibular advancement is associated with unsightly fullness at the base of nose, upturned tip of nose, saddle deformity of the nasal bridge, and lack of upper lip curve.

That's exactly what I ended up with. My upper lip curves in the wrong direction. 

[geijutsu]

The asian guy looks like he's had a pre-maxillary implant, a rhino alone can't fill in around the nasal base.

[jaws]

By the way, his masking surgeries costed way too much.  Might as well just get jaw surgery and actually fix the issue.

Some patients end up in the same situation like the woman above. If your occlusal plane angle is good, CCW rotation can't be used but you need a large advancement. In this situation, a large advacement may have drawback but can still be a better option than a minor advancement. Of course, there're other midface osteotomies in addition to LF1 but most people aren't going to get them although LF1 might be a compromise for them. The question then arises. How does one correct  unaesthetic nose, nasal base fullness and lack of upper lip curve after a LF1?

[PloskoPlus]

How does ccw prevent nasal base fullness and a straight lip?  It still involves advancement of the maxilla.

[jaws]

How does ccw prevent nasal base fullness and a straight lip?  It still involves advancement of the maxilla.

"CCW MMA produces the least advancement at the base of nose solving the esthetic complication of straight advancement surgery. Also of benefit, with CCW MMA, the greatest advancement occurs at the base of tongue which Rama noted as the most common site of OSA."

[jaws]

A good surgeon will not let that monkey scowl happen... and if that's the only option you've got then, I'd rather not get the jaw surgery and live with a decent face rather than looking like a monkey.

Some just can't have it all.

I used to believe that as well but I've seen former patients of so called "top surgeons" and some of them have this problem. Again, I'm not saying they didn't improve but some aspect of their profile became worse. In these cases LF1 was still better than nothing.