Role of the mandible in midfacial soft tissue distribution?

[triot]

When looking through the internet I always find information, on how the lower jaw affects the neck and under-chin area, but not so much about it's role on the cheeks.

My problem is that my mandibular body (not the alveolar process) grew kinda steep, my occlusional plane is flat and I apparently do not have a skeletal/dental malocclusion (see cephs here: http://jawsurgeryforums.com/index.php?topic=4840.msg40185#msg40185) and that's why I wonder why I have this flab on my face since I always thought the maxilla plays the major role on this matter. The excess skin is situated especially on the lower, anterior part (on the sides of my mouth) of my face. I do however suspect that my extreme wightloss last year further traumatised the skin.

I feel like the tissue is congested up to the lower part of my Zygos, taking away some prominence of it, that it increases my nasolabial folds and that it congests my mouth horizontally. Does this sound logical?

[triot]

I think I agree with you.

My guess is that this is for two reasons:

1. Downward, as opposed to forward and outward grown facial type. Hard to completely change due to the set vertical lengths of the nose, midface, zygomas.

2. Lots of skin needed to stretch down the whole vertical length of the face, but because of the growth trend, which is commonly accompanied by a short ramus (shorter than the ratio between ramal and chin height in a person with the forward and outward growth habit), not enough bone height at the back to pull this skin tight... basically tall in the front and short in the back.

I'm not an expert, but to me it seems that your occlusal plane could be flatter.. maybe CCW, or jaw angle implants.

Alternatively, you could have BDD and both of us are just imagining.

Well, I read that the occlusal plane in modern day skulls is never horizontally flat, the mandible just wouldn't allow it (it was flat in neaderthalers though). I thought that this difference in hight is what's called the 'Curve of Spee'. This curve is commonly exaggerated in individuals with a deep overbite, which I obviously don't have. I went to two of the best orthos in my region and both said I "have a bite from the textbook" (even though one of them mentions class two in his letter, but also a user here confirmed that I have a neutroclusion). Ofc I don't want to delude myself and I could very well be wrong, but...

even if, I really don't see how a CCW could work for me. I don't have maxiallry excess. There's like 3 mm of distance between the roots of my teeth and this little piece of bone on the bottom of my nose. You'd have to cut the roots away to cut a significant enough amount of bone to rotate and take all the tooth show away. And it isn't short either I guess, since I have normal (I think) tooth show at rest, so moving the entire upper jaw down would result in a gummy smile.

It's f*cking frustrating to really see that something is wrong with your face/head from the outside, but there doesn't seem to be any explanation, where I could really start to work on.