Small Mandible - Need Extractions Prior to BSSO?

[JayJaw]

I just got back from initial consultation with Dr. Sachs (NYC). While he said he has to look things over to come up with more concrete plan (going back in a week), he told me the following:

My mandible is small and crowded. The lower teeth flare significantly forward (tongue thrust) to meet the top teeth. In order to move the lower jaw, two teeth must be removed and pulled back to create and overjet. This will then be moved forward surgically for correct bite. Lefort and genioplasty also discussed.

Is this standard? I am going to wait until next week when he has concrete plan to really discuss concerns and such... this being one of them. I want to avoid extraction at all costs. However, I do understand that it is likely impossible to move my teeth backwards enough as my jaw is now to straight the tilt of the bottom teeth. However, why not do the surgery first, give me an underbite (and all my teeth) then move those back to fill the space created?

I am going to request pictures/ceph and can get further thoughts from you guys, but wanted to know if extraction like above can be avoided in my case (tongue thrust, mouth breather, recessed chin, etc.).

[molestrip]

Remember, you don't have to rush into anything.  Take the time to make a good decision.

Good advice. Just wisdom teeth but I already made this mistake. All professionals have different techniques and opinions, don't settle for a suboptimal result until you've heard from several that you have to. Or you will regret not trying, I know first hand. Also keep in mind that holding out is also an option, maybe not today but perhaps in 5 years if you can afford to wait.